Pharyngolaryngeal edema as a presenting symptom in preeclampsia

Pharyngolaryngeal edema, a rare and serious complication of obstetric anesthesia, was associated with preeclampsia in four of seven reported cases. The authors treated two severely preeclamptic women with this complication who required general anesthesia for cesarean section. In both women, gentle direct laryngoscopy under topical anesthesia of the oropharynx was undertaken to detect possible difficulty in endotracheal intubation. Based on the findings at laryngoscopy, one patient was intubated while awake and breathing spontaneously. The other patient could be managed safely in the usual manner. Postoperatively, both women were nursed in an intensive care unit until after the airway problem had subsided.