Maternal pulmonary edema resulting from betamimetic and glucocorticoid therapy.
Four cases are presented of maternal pulmonary edema occurring in patients who had no primary cardiac disease but who were receiving terbutaline and glucocorticoids or terbutaline alone for treatment of premature labor. Fluid overload was the event that triggered this decompensation. The physiologic high-output cardiac state of pregnancy is described and the manner in which betamimetic drugs and corticosteroids exacerbate this situation and cause congestive heart failure is shown. Methods of management to avoid this complication of premature labor therapy are suggested.
D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D002302:Cardiac Output / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006333:Heart Failure / Q000139:chemically induced; D006801:Humans; D007752:Obstetric Labor, Premature / Q000188:drug therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000139:chemically induced*; D011249:Pregnancy Complications, Cardiovascular / Q000139:chemically induced; D011654:Pulmonary Edema / Q000139:chemically induced*; D013726:Terbutaline / Q000009:adverse effects; D014882:Water-Electrolyte Balance
D000318:Adrenergic beta-Agonists; D005938:Glucocorticoids; D013726:Terbutaline