Background: Pre-eclampsia remains an important cause of hypertensive acute pulmonary edema in pregnancy. Acute pulmonary edema, which signifies severe disease, is a leading cause of death in pregnant women with pre-eclampsia and a frequent cause of admission to intensive care unit.

Objective: To examine pulmonary edema’s prevalence and associated factors among severe pre-eclamptic pregnant women.

Materials and Methods: The present study was an analytic retrospective case-control study. Five hundred fifty-eight gestational-age pregnant women diagnosed with pre-eclampsia with severe features according to the ACOG 2013 guidelines delivered at Pattani Provincial Hospital between July 2021 and April 2023 were enrolled by retrospective review the hospital records. Four hundred severe pre-eclamptic women met the inclusion criteria. Fifty-one pregnant women with severe pre-eclampsia who developed pulmonary edema were included as cases, and 204 severe pre-eclamptic women who did not develop pulmonary edema were included in cases for a ratio of 1 to 4. The statistical analyses involved the two groups. Multiple logistic regression analysis, odd ratio, and 95% confidence interval (CI) were performed.

Results: Among severe pre-eclamptic pregnant women, the associated factors for severe preeclamptic women decreased 69% (95% CI 0.1 to 0.9) with nulliparous, decreased 88% (95% CI 0.0 to 1.1) with the first blood pressure level of more than 180/120 mmHg, decreased 98% (95% CI 0.0 to 0.1) with epigastric pain as presenting symptoms. However, the associated factors for pulmonary edema increased 2.04 (95% CI 1.0 to 4.0) times with the number of antenatal care visits of less than eight times and increased 2.79 (95% CI 1.4 to 5.6) times with gestational diabetes mellitus.

Conclusion: The prevalence of pulmonary edema among severe pre-eclamptic women was 12.75%. The factors associated with pulmonary edema among severe pre-eclamptic women included gestational diabetes mellitus and poor antenatal care of less than eight visits. 

Received 19 January 2024 | Revised 23 April 2024 | Accepted 30 April 2024

DOI:10.35755/jmedassocthai.2024.6.13997