NEKARDIOGENI EDEM PLUĆA NAKON CARSKOG REZA

Acute dyspnea during and after pregnancy should bring a number of important conditions to the mind of a physician. Pulmonary embolism, amniotic fl uid embolism, pneumonia, aspiration and pulmonary edema must be considered. Although pulmonary edema is a very rare condition, the most common contributing factors include the administration of tocolytic agents, underlying cardiac disease, iatrogenic fluid overload and preeclampsia. We report on a case of noncardiogenic pulmonary edema in a 36-year-old woman a few hours after cesarean section. The acute event was probably due to iatrogenic fl uid overload combined with hemodynamic effects of oxytocin in interaction with hemodynamic changes at the end of pregnancy. The patient was successfully treated with diuretics and oxygen therapy, and after a few hours her chest radiograph and respiratory status were normal.Pojava akutne dispneje za vrijeme i nakon trudnoće treba pobuditi sumnju na nekoliko važnih diferencijalnih dijagnoza kao što su plućna tromboembolija, embolija amnionskom tekućinom, pneumonija, aspiracija i plućni edem. Plućni edem se javlja rijetko i obično je precipitiran tokolizom, već postojećom bolesti srca, volumnim preopterećenjem ili preeklampsijom. Opisujemo slučaj 36-godišnje bolesnice s nekardiogenim edemom pluća koji se manifestirao nekoliko sati nakon carskog reza kao rezultat volumnog opterećenja te istodobnog antidiuretskog djelovanja oksitocina i hemodinamskih promjena pred kraj trudnoće. Bolesnica je uspješno liječena diureticima i oksigenoterapijom. Nekoliko sati kasnije kontrolna slika srca i pluća i respiracijski status bili su normalni, a bolesnica nedugo zatim otpuštena iz bolnice