title: [Acute pulmonary edema and pregnancy: a descriptive study of 15 cases and review of the literature].
abstract: OBJECTIVE
  To describe the incidence and the etiologies of acute pulmonary edema (APE) and the diagnostic procedure used during pregnancy and immediate post-partum.
  
  
  METHODS
  We analyzed records from a search of codes of heart failure and APE as well as from the term "pulmonary edema" in computerized obstetric records from 2002 to 2010 in a university center of level 3. We identified maternal characteristics, the term of appearance and route of delivery, the time between symptoms and diagnosis, additional tests performed, and data from echocardiography.
  
  
  RESULTS
  Fifteen patients had an APE during pregnancy or in the immediate post-partum period during the study period (0.05%). The mean age was 28.6 years and the mean term of appearance was 31.2±3.1 weeks of amenorrhea. The diagnosis was made in 11 cases (73.3%) before delivery and in four during post-partum. The main etiology was preeclampsia (46.6%) followed by heart disease (26.7%), then tocolysis and overfilling (13.3%). In 55% of cases, we found a diagnostic wander characterized by carrying out further unnecessary tests. The echocardiography has led to a change in management in 27.3% of cases.
  
  
  CONCLUSIONS
  The APE is a rare event during pregnancy and the post-partum period and its main etiology is preeclampsia. Some other etiologies are avoidable like the use of beta-agonists by intravenous route. The diagnosis is sometimes difficult, but the realization of a chest X-ray, a simple and inexpensive test, is enough to confirm it.
authors.affiliation: Service de gynécologie-obstétrique et médecine de la reproduction, CHU de Caen, Caen cedex 9, France. dolley-p@chu-caen.fr
authors.forename: P
authors.initials: P
authors.lastname: Dolley
authors.forename: A
authors.initials: A
authors.lastname: Lebon
authors.forename: G
authors.initials: G
authors.lastname: Beucher
authors.forename: T
authors.initials: T
authors.lastname: Simonet
authors.forename: M
authors.initials: M
authors.lastname: Herlicoviez
authors.forename: M
authors.initials: M
authors.lastname: Dreyfus
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D005865:Gestational Age; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D011225:Pre-Eclampsia / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000503:physiopathology; D011644:Puerperal Disorders / Q000175:diagnosis / Q000209:etiology; D011654:Pulmonary Edema / Q000175:diagnosis* / Q000209:etiology; D015145:Tocolysis / Q000009:adverse effects