Capillary leak syndrome following cesarean section in a patient with severe preeclampsia: a case report

Capillary leak syndrome (CLS) is a rare, often idiopathic condition, typically characterized by edema, hypotension, hypovolemic shock, and hypoalbuminemia. The progression of CLS is rapid, with a complex clinical course. If left undiagnosed or untreated, CLS can cause multiorgan failure and significantly increase the risk of mortality. Although CLS is generally associated with conditions such as infections, trauma, or autoimmune disorders, the occurrence of the condition following a cesarean section in patients with severe preeclampsia is exceedingly uncommon.

A 37-year-old pregnant woman at 37 weeks of gestation underwent a cesarean section due to severe preeclampsia. Postoperatively, the patient developed sudden hypoxemia, massive ascites, oliguria, hypotension, and hypoalbuminemia. Following prompt identification and diagnosis, treatment was initiated with blood pressure management, magnesium sulfate to alleviate spasms, and supplementation with hydroxyethyl starch, albumin, and crystalloids. Additionally, corticosteroids were administered to improve capillary permeability. The condition was rapidly managed, with subsequent follow-up revealing no recurrence of similar issues.

To the best of our knowledge, this is the first documented case of CLS occurring following a cesarean delivery in a patient with severe preeclampsia. The successful management of this patient offers valuable insights into early diagnosis, prompt treatment, and the potential to improve the prognosis of similar cases.