Acute cardiogenic pulmonary edema and pregnancy: a ten-year experience

We reviewed the cardiac emergencies that occurred during or soon after pregnancy and required admission in an intensive care unit. The study sample consisted of 22248 pregnant women representing the whole obstetrical population collected from 3 hospitals over a ten-year period. Among the 88 patients admitted to our ICU during this decade, only 5 suffered from a specific cardiac disorder. Acute pulmonary edema was the common clinical presentation in the 4 cases reported. Despite the severity of cardiac involvement on admission none had previous evidence of heart disease that could have heralded acute left ventricular failure. From these observations it can be concluded that preexisting cardiovascular disease and circulatory changes related to pregnancy should no longer be regarded as the unique contributors to the development of severe heart failure during pregnancy.