Pulmonary edema during cesarean section related to the use of oxytocic drugs

We report the case of an acute pulmonary edema occurring during cesarean section under general anesthesia in a previously healthy negro parturient. This acute event was probably due to the hemodynamic effects of three oxytocic drugs, oxytocin, methylergometrine maleate and prostaglandin F2 alpha used to control severe third-stage bleeding in interaction with the hemodynamic effects of pregnancy at term and surgical and anesthetic stress. The cardiovascular effects of these drugs are reviewed. For a safer conduct of anesthesia, oxytocin for control of uterine bleeding is recommended to be administered by slow intravenous drip and ergometrin by intramuscular injection. The safety of the intramyometrial injection of PGF2 a still remains to be proven.

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