Nicardipin Associated Pulmonary Edema : A Severe Complication of Tocolysis - A Case Report

Abstract

In preterm labor, tocolytics are used to stop uterine contractions and to allow the administration of corticosteroids for fetal lung maturation, nicardipine is a calcium channel blocker increasingly used for this indication. Several adverse effects have been reported during tocolysis using nicardipine, one of the most serious complications is Acute Pulmonary Edema. We report a case of a parturient who has admitted at 28 weeks of pregnancy for preterm labor and developed a respiratory failure two days following tocolysis with nicardipine. Echocardiography and Computed Tomography Pulmonary Angiography (CTPA) ruled out a pulmonary embolism and a decompensated heart disease. The patient received oxygen therapy and diuresis for Acute Pulmonary Edema with favorable outcomes.The purpose of this paper is to discuss the risk factors for the occurrence of pulmonary edema after tocolysis, the importance of the etiologic investigation to exclude differential diagnoses and therapeutic options for management of this complication.