Late postpartum preeclampsia induced acute pulmonary edema, a rare presentation of a common disease: A case report

Abstract

Preeclampsia is a disorder of widespread vascular endothelial dysfunction and vasospasm associated with pregnancy. It can occur from the 20th week to 4-6 weeks postpartum, resulting in hypertension, proteinuria and, in severe cases, end-organ damage and death. A 31-year-old puerpera enters the emergency room with complaints of dyspnea and leg edema, two weeks after the delivery. She was polipneic and hypertensive, had vascular congestion on thorax x-ray, elevated d-dimers and NT-proBNP. Meanwhile pulmonary embolism was suspected, she developed an acute pulmonary edema. Exams excluded embolism and cardiac abnormalities. New onset proteinuria allowed to diagnose a severe postpartum preeclampsia. About 5.7% of preeclampsia occurs in the postpartum but this is sometimes neglected. As progression to eclampsia isn’t influenced by control of hypertension or severe symptoms and seizure complications are a major cause of morbimortality, its recognition and institution of prophylaxis with magnesium sulphate is crucial.

Keywords

• Postpartum preeclampsia
• Severe preeclampsia
• Pulmonary edema.