Hemodynamic observations in severe preeclampsia complicated by pulmonary edema

Ten patients with severe preeclampsia complicated by pulmonary edema were studied with invasive hemodynamic monitoring. Eight of 10 patients developed pulmonary edema during the postpartum period. Five patients had alterations in the colloid osmotic pressure--pulmonary artery wedge pressure gradient related to elevations in the pulmonary artery wedge pressure and a reduction in the colloid osmotic pressure. Three patients had hemodynamic findings consistent with pulmonary capillary leak. Two patients had evidence of left ventricular failure. In three of the patients, the central venous pressure was significantly lower than the simultaneously determined pulmonary artery wedge pressure during the acute phase of the pulmonary edema.