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J Matern Fetal Neonatal Med. 2018 Mar;31(6):689-695. doi: 10.1080/14767058.2017.1295442. Epub 2017 Mar 1.

Pulmonary edema in preeclampsia: an Indonesian case-control study.

Author information

1
a Maternal Fetal Medicine Division, Department of Obstetrics & Gynecology , Fakultas Kedokteran Universitas Airlangga , Surabaya , Indonesia.
2
b Department of Obstetrics & Gynaecology , University of Adelaide , Elizabeth Vale , SA , Australia.

Abstract

OBJECTIVE:

To analyze risk factors, obstetric outcome and the need for mechanical ventilation in preeclampsia complicated by pulmonary edema.

MATERIALS AND METHODS:

Case-control study using medical record on preeclampsia complicated by pulmonary edema patients in East Java tertiary referral hospital over 2 years. A simple scoring system was developed to predict the need for mechanical ventilation, using logistic regression.

RESULTS:

1106 cases of preeclampsia were admitted, with 62 cases (5.6%) had pulmonary edema. Postpartum (p < .001) and cesarean delivery (p = .001) proportions were higher in the preeclampsia with pulmonary edema group. Of the 62 cases with pulmonary edema, 81% required intensive care admission and 60% needed mechanical ventilation support. Mechanical ventilation used was associated with eclampsia (p = .04), hypertensive crisis (p = .02), lower serum albumin (p = .05) and higher creatinine (p = .01). A simple scoring model developed could predict a 46%-99% probability of need for mechanical ventilation (AUC (ROC): 0.856, 95%CI 0.763-0.95).

CONCLUSIONS:

Pulmonary edema is a common complication of preeclampsia in Indonesian referral hospitals. This severe complication increased maternal and perinatal morbidity and mortality. The developed scoring model in this study can be used as a triage tool to predict the probability of mechanical ventilation use due to this complication.

KEYWORDS:

Preeclampsia; mechanical ventilation; pulmonary edema

PMID:
28282767
DOI:
10.1080/14767058.2017.1295442
[Indexed for MEDLINE]

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