[Lesional pulmonary edema associated with tocolysis by hexoprenaline sulfate].
We report the case of a 24-year-old white female in need of tocolysis during the 25th week of pregnancy with i.v. hexoprenaline, while suffering from a discrete influenza-like syndrome with nasal discharge and sinusitis. A few hours later fulminant acute adult respiratory distress syndrome (ARDS) developed. ARDS is a rare (0.5-5%) but feared complication of tocolysis with beta-2 mimetic agents and magnesium sulfate. Its physiopathology is obscure, but iatrogenic hyperhydration and lesions of the alveolar-capillary membrane are suspected. In this case both factors were involved, but lesions of the alveolar-capillary membrane were predominant. A direct toxic effect of beta-2 mimetic agents on the alveolar-capillary membrane has not been demonstrated and other factors favoring pulmonary edema during tocolysis with beta-2 mimetic agents, especially infections, are discussed.
Rivier
G
G
Service de médecine interne, Hôpital cantonal, Fribourg.
Nicole
A
A
Stucki
D
D
Regamey
C
C
D000328:Adult; D002245:Carbon Dioxide / Q000097:blood; D002585:Cesarean Section; D003422:Critical Care; D005260:Female; D006594:Hexoprenaline / Q000009:adverse effects*; D006801:Humans; D000860:Hypoxia / Q000503:physiopathology; D007231:Infant, Newborn; D010100:Oxygen / Q000097:blood; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced*; D011262:Pregnancy Trimester, Second; D012128:Respiratory Distress Syndrome / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy; D015149:Tocolytic Agents / Q000009:adverse effects*
D015149:Tocolytic Agents; D002245:Carbon Dioxide; D006594:Hexoprenaline; D010100:Oxygen
Oedème pulmonaire lésionnel associé à une tocolyse par le sulfate d'hexoprénaline.