A case report on acute pulmonary edema induced by adverse drug event immediately after cesarean section

Acute pulmonary edema is excessive fluid accumulation in the interstitial and alveolar spaces. Although acute dyspnea during pregnancy and the immediate postpartum period is uncommon, it should alert the attending health professional to several important conditions.

A 23-year-old female patient with Gravida 2 and Para 1 mother presented with acute shortness of breath approximately 1 h after delivery by an emergency cesarean section under spinal anesthesia. Immediately after transferring to the recovery room, her vital signs were Bp, 80/56 mmHg, HR = 64BPM, RR, 18, and oxygen saturation of 95 % while she breathed with room air. Immediately after 1 h, the patient reported a history of mild cough that progressed to severe shortness of breath and chest heaviness while she was lying supine.

Acute pulmonary edema is an infrequent cause of postpartum and pregnancy-related respiratory failure. This potentially fatal condition is characterized by noncompliant or "stiff" lungs and insufficient oxygenation. This condition is linked to widespread alveolar damage and capillary endothelial injury.

Pregnancy-related pulmonary edema, which may occur with or without pre-eclampsia and may happen with a medication adverse effect, is a serious emergency that has a high death rate if left untreated. Appropriate treatment and early screening may improve patient outcomes.