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High permeability pulmonary edema (ARDS) during tocolytic therapy--a case report.
E W Russi1, L Spaetling, J Gmür
1Department of Internal Medicine, University Hospital, Zurich, Switzerland.
Journal of Perinatal Medicine
|January 1, 1988
Summary
Beta-sympathomimetic drugs like fenoterol may cause pulmonary edema in pregnant women by increasing alveolar-capillary membrane permeability. This risk is heightened with fluid overload, necessitating careful monitoring during premature labor treatment.
Area of Science:
- Obstetrics and Gynecology
- Pulmonology
- Pharmacology
Background:
- Premature labor is often managed with beta-sympathomimetic drugs.
- Fenoterol is a beta-2 adrenergic agonist used for tocolysis.
- Pulmonary edema is a potential serious adverse event in pregnancy.
Observation:
- A 26-year-old woman treated with fenoterol for premature labor developed severe pulmonary edema.
- The patient required intubation and mechanical ventilation.
- Right heart catheterization ruled out left ventricular failure.
Findings:
- Lung edema fluid analysis indicated increased pulmonary capillary permeability.
- This suggests a direct effect of fenoterol on alveolar-capillary membrane integrity.
- Recovery was rapid after discontinuation of the drug and supportive care.
Implications:
- Beta-sympathomimetic tocolytics may increase pulmonary capillary permeability.
- Fluid overload can act as a triggering factor for drug-induced pulmonary edema.
- Clinicians should be vigilant for pulmonary edema in patients receiving beta-sympathomimetic therapy, especially with concurrent fluid administration.