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Background and Aims We will attempt to review the pathophysiology of preeclampsia, the relevant literature and up-to-date guidelines regarding the appropriate measures for effective treatment of both preeclampsia and pulmonary edema and research the association of the aforementioned events with the newborn’s pathology.

Methods We are going to present a singular case of a woman with preexisting, untreated, moderate hypertension before conception that developed preeclampsia during caesarian section under spinal anesthesia with acute pulmonary edema as the first presentation. The patient remained hemodynamically stable with minimal fluctuation of her blood pressure up until thirty minutes after delivery when she complained about dyspnea and severe headache with a concurrent spike in her blood pressure and auscultatory crackles in her lungs.

Results The patient was diagnosed early and treated successfully with diuretics, hypertensive therapy, supplementary oxygen and anti-Trendelenburg position with no further incidents until her discharge from PACU. The newborn developed ARDS minutes after birth requiring intubation and mechanical ventilation despite exhibiting no symptoms at the time of delivery.

Conclusions Pulmonary edema is a rare complication of pregnancy usually associated with preeclampsia and requires the immediate intervention of the anesthesiologist team when it occurs during delivery. Preeclampsia requires vigilant monitoring even after postpartum and the contribution of different specialists to ensure a positive outcome for both the mother and the infant.

Attachment Abstract – Pulmonary edema as a first symptom of preeclapmsia intrapartum.docx