Acute pulmonary edema as a complication of urinary infection in pregnant women: a case report

Introduction: Urinary infection (UI) is the third most common pathology during pregnancy, affecting 10-12% of pregnant women in the first trimester. Thus, the prenatal care is important to reduce indicators of maternal-fetal mortality, promoting quality of life during pregnancy and postpartum. Objective: The aim of this study is to report the case of a pregnant woman with pyelonephritis, who evolved with acute pulmonary edema. Case report: The present study was elaborated according to the rules of CARE case report. This study was analyzed and approved by the Research Ethics Committee (CEP) according to a substantiated opinion number 4,375,418 and obtaining the patient's consent. The present study therefore highlights pyelonephritis as the most severe form of UI in pregnant women, associated with septic shock, with evolution to respiratory failure, resulting from acute pulmonary edema, and may be related to worse maternal-fetal prognoses. This clinical study contributes to the literature, emphasizing that, currently, all forms of UI during pregnancy should be considered as great potential for complications, and should be treated even in its asymptomatic form. Conclusion: It is evident the need for early intervention to minimize maternal-fetal losses, unnecessary interventions and to reduce costs in relation to additional treatments. The importance of rapid diagnosis and early treatment is emphasized in order to minimize or extinguish the damage. As well as promoting actions to encourage pregnant women to perform prenatal care.

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Acute pulmonary edema as the initial presentation of a pheochromocytoma: case report

Endocrine Abstracts ◽

10.1530/endoabs.32.p235 ◽

2013 ◽

Author(s):

Eduarda Resende ◽

Maritza Sa ◽

Margarida Ferreira ◽

Silvestre Abreu

Keyword(s):

Case Report ◽

Pulmonary Edema ◽

Initial Presentation ◽

Acute Pulmonary Edema

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POS0997 PERFORMANCE OF ASDAS VERSUS BASDAI DURING PREGNANCY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.2859 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 767.1-767

Author(s):

P. Fischer ◽

A. Zbinden ◽

F. Foerger

Keyword(s):

Disease Activity ◽

Pregnant Women ◽

Global Assessment ◽

Signs And Symptoms ◽

First Trimester ◽

Point Estimation ◽

High Disease Activity ◽

Physician Global Assessment ◽

Pregnancy And Postpartum ◽

Pregnant State

Background:Disease activity in patients with axial spondyloarthritis (axSpA) can be measured by BASDAI and ASDAS. Both instruments were validated in non-pregnant patients with cutoff values for active diseases. In pregnant women with axSpA, however, BASDAI and ASDAS scores might be biased by signs and symptoms of pregnancy itself.Objectives:To compare the performance of ASDAS and BASDAI during pregnancyMethods:Patients with axSpA were prospectively followed before pregnancy, at each trimester and 6 to 12 weeks postpartum. Disease activity was assessed by BASDAI, ASDAS, patient global assessment (PGA) and physician global assessment (PhGA). We analysed the disease course throughout pregnancy and postpartum, the correlation between BASDAI and ASDAS and the agreement in the classification of active disease. We applied receiver operating curves (ROC) to evaluate the cut-off points in pregnant patients.Results:The study involved 40 women with axSpA. Disease activity scores were higher during pregnancy (median ASDAS score: 2.5, median BASDAI score 3.1) than during a non-pregnant state (median ASDAS score 2.3, median BASDAI score 2.1). Median BASDAI scores were highest at the first trimester, median ASDAS scores were highest at the second trimester. ASDAS strongly correlated with BASDAI, both in the pregnant and in the non-pregnant state (r=0.796, r=0.727). However, there was a discordance when analysing the proportion of patients with high disease activity using the common cut-off values (ASDAS >2.1, BASDAS >4). More patients had high disease activity when measured by ASDAS (1st trimester (T): 63%, 2nd T: 76%, 3rd T: 61%) compared to those measured by BASDAI (1st T 43%, 2nd T: 39%, 3rd T: 34%). The κ coefficient showed only fair agreement (κ=0.39). ROC analysis among pregnant patients showed that the cut-off point estimation for high disease activity using ASDAS >2.75 corresponded to a BASDAI >4. The ASDAS >2.75 cut-off for high disease activity had a good agreement with BASDAI >4 (κ=0.657). When ASDAS >2.75 was applied in pregnant women with axSpA, about 40% experienced high disease activity.Conclusion:During pregnancy, the majority of women with axSpA experience ongoing disease activity. However, the cut-off values defining low and high disease activity might differ between pregnant and non-pregnant individuals since BASDAI and ASDAS are biased by pregnancy related symptoms like fatigue and mechanical back pain.Disclosure of Interests:None declared.

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