Asthma in pregnancy complicated by iatrogenic pulmonary oedema

• Published in: Postgraduate Medical Journal Vol. 65; no. 764; pp. 407 - 409
• Main Authors: Hardy, C. C., Lorigan, P., Ratcliffe, A., Carroll, K. B.
• Format: Journal Article Book Review
• Language: English
• Published: England The Fellowship of Postgraduate Medicine 01.06.1989; Oxford University Press; BMJ Group
• Subjects: Acute Disease; Adult; Asthma - drug therapy; Female; Humans; Iatrogenic Disease; Obstetric Labor, Premature - prevention & control; Pregnancy; Pregnancy Complications - drug therapy; Pulmonary Edema - chemically induced; Ritodrine - adverse effects
• ISSN: 0032-5473; 1469-0756
• DOI: 10.1136/pgmj.65.764.407

We report a unique case of near fatal acute pulmonary oedema developing with intravenous ritodrine, given in an attempt to suppress premature labour. The novel aspect of the case is that the patient had also been treated in the previous week with high dose nebulized beta-agonists for an episode of acute severe asthma, demonstrating that this idiosyncratic reaction to beta-adrenergic agents only occurs with the intravenous route of administration. The management of acute severe asthma occurring in pregnancy is discussed with a review of previous literature regarding possible mechanisms of beta 2-agonist-induced pulmonary oedema.