Hypertension in Pregnancy, Early Online:1–13, 2009
Copyright © Informa UK Ltd.
ISSN: 1064-1955 print / 1525-6065 online
DOI: 10.3109/10641950902972140
LHIP 1064-1955 1525-6065 Hypertension in Pregnancy, Vol. 1, No. 1, June 2009: pp. 1–25 Hypertension in Pregnancy
Acute Pulmonary Oedema
as a Complication of
Hypertension During
Pregnancy
Acute Pulmonary Oedema During Pregnancy Thornton et al.
Charlene E. Thornton,
1
Peter von Dadelszen,
2
Angela Makris,
3
Jane M. Tooher,
4
Robert F. Ogle,
4
and Annemarie Hennessy
1
1
School of Medicine, University of Western Sydney, Sydney, Australia
2
University of British Columbia, British Columbia Women’s Hospital and Health
Centre, Maternal-Fetal Medicine Unit, Vancouver, Canada
3
Heart Research Institute, University of Sydney, Sydney, Australia
4
Hypertensive Disorders of Pregnancy Unit, Royal Prince Alfred Women and Babies,
Sydney, Australia
Objective. To determine rates of and potential causative factors for acute pulmonary
oedema (APO) in hypertensive women. Methods. Statistical analysis, including logis-
tic regression, was applied to the individual patient data (IPD) of all hypertensive
women who delivered in 2005 at two comparable units. Results. Of 880 cases
analysed, there were no women with APO in unit one and 19 women in unit two. The
women with APO received larger quantities of intravenous fluids, delivered at earlier
gestations, via Caesarean section, following failed induction of labour and had a longer
hospital stay. Conclusion. The development of APO in women with hypertension
during pregnancy is associated with high levels of intravenous fluid administration.
Keywords Acute pulmonary oedema, Hypertension, Preeclampsia.
INTRODUCTION
Hypertensive disorders in pregnancy contribute to significant mortality and
morbidity worldwide, and affect 5% of pregnancies. Rapid onset interstitial
fluid accumulation in the lungs, acute pulmonary oedema (APO), is a poten-
tial complication of maternal hypertension, seen particularly in women with
preeclampsia and eclampsia. APO has also been linked to increased maternal
age, delivery via Caesarean section, body mass index, parity, undiagnosed
Address correspondence to Charlene E. Thornton, Locked Bag 1797, University of West-
ern Sydney, School of Medicine, Penrith South, DC NSW 1797.
E-mail: charlene.thornton@ uws.edu.au
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