Details

Autor(en) / Beteiligte

• Katz, Leila
• Pordeus, Ana Carolina Barbosa
• Truta, Amanda Carla Lyra
• Queiroz, Rafaella Correia Tiburtino
• Soares, Mariana Carvalho
• Maia, Sabina Bastos
• Amorim, Melania Maria Ramos

Titel

118 Clinical and epidemiological profile of obstetrics patients with hypertensive acute pulmonary edema hospitalized in a intensive care unit

Ist Teil von

• Pregnancy hypertension, 2016-07, Vol.6 (3), p.236-237

Erscheinungsjahr

2016

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Introduction Hypertensive acute pulmonary edema (APE) in obstetrics is a rare event, but in pregnancies with preeclampsia becomes more condom e is important cause of hospitalization in ICU. Objective To describe clinical and epidemiological profile of patients with hypertensive APE hospitalized in ICU. Methods A cross-sectional study including 41 patients admitted with diagnosis of APE between 2012 and 2015. Data analysis was performed with Epi Info Program version 7.1.5 and used frequency measures and dispersion center. The study was approved by the Research Ethics Committee of the institution (CAAE: 33479414.4.0000.5201). Results Mean age was 26.7 years; 60.9% were from Recife and metropolitan area; 53.3% had eight to eleven studied years; 54% were primiparous. In 58.5% of the cases the APE occurred postpartum, 39% antepartum and 2.4% intrapartum; 7.3% already had previous APE episode, 4.8% recurred and 4.8% died. Cesarean section occurred in 80.4% and spinal anesthesia was the most common with 57.5%; patients that developed APE antepartum and were submitted to cesarean section were 54.5% and postpartum women who were submitted to cesarean section and developed APE were 42.2%. Time between diagnosis and resuscitation maneuvers was five minutes in 55.8% and 75% within 30 min of patients. In the 24 h preceding the APE, 24.3% had fluid overload; although oliguria occurred in 17% of patients. Oxygen mode most common was Venturi mask in 73.1% of patients; 24.3% required intubation; 26.8% used noninvasive ventilation. Echocardiography after APE diagnosis was made in 90.2% and heart disease associated was found in 24.3%. Near miss criteria were present in 56.1% of patients, the most common was the respiratory disorders in 43.9% and hypoxemia was the most frequent in 26.8%. The mean of ICU hospitalization was six days and hospital 12 days. Birth before 37 and 34 weeks occurred in 75.0% and 37.5% respectively; Apgar scores in the first and in the fifth minute under seven were 38.9% and 20.5% respectively. Neonatal resuscitation occurred in 12.7% of fetuses, 17% required noninvasive ventilation and 10.6% intubation. Respiratory distress was the most common neonatal disease with 53,8%, mild to moderate neonatal hypoxia occurred in 16.9% of the neonates, fetal death in 10,2%, admission to neonatal ICU in 25.6% and neonatal death in 10.2%. Conclusion APE occurred more frequently antepartum and the cesarean section was the most common delivery form. This severe disease associated with high morbidity and mortality for mother and fetus. Fluid overload seems to have importance in triggering the hypertensive APE. Echocardiogram after APE diagnosis is important to diagnose associated heart disease.