Pulmonary edema in preeclampsia: an Indonesian case-control study

Area of Science:

• Obstetrics and Gynecology
• Critical Care Medicine
• Pulmonary Medicine

Background:

• Preeclampsia is a serious pregnancy complication characterized by high blood pressure.
• Pulmonary edema, fluid in the lungs, is a severe manifestation of preeclampsia.
• Understanding risk factors and outcomes is crucial for managing preeclampsia with pulmonary edema.

Purpose of the Study:

• To identify risk factors associated with preeclampsia complicated by pulmonary edema.
• To analyze obstetric outcomes in patients with preeclampsia and pulmonary edema.
• To assess the need for mechanical ventilation and develop a predictive model.

Main Methods:

• A case-control study was conducted using medical records from a tertiary referral hospital in East Java.
• Data from 1106 preeclampsia cases were analyzed over two years.
• A logistic regression model was used to develop a scoring system for predicting mechanical ventilation needs.

Main Results:

• 62 cases (5.6%) of preeclampsia presented with pulmonary edema.
• Patients with pulmonary edema had higher rates of postpartum and cesarean delivery.
• 81% of these patients required intensive care, and 60% needed mechanical ventilation, associated with eclampsia, hypertensive crisis, low albumin, and high creatinine.

Conclusions:

• Pulmonary edema is a significant complication of preeclampsia in Indonesian hospitals, leading to increased maternal and perinatal morbidity and mortality.
• A developed scoring model demonstrates high accuracy (AUC: 0.856) in predicting the need for mechanical ventilation.
• This scoring tool can aid in the triage and management of preeclampsia patients with pulmonary edema.