[Ritodrine induced pulmonary edema after caesarean section for a triplet pregnancy]. 1994

T Yamauchi, and K Kuzume, and S Hirata, and Y Yamauchi, and T Senda, and G Hamami, and T Arai
Department of Anesthesiology and Resuscitology, School of Medicine, Ehime University.

Selective beta-sympathomimetic drugs are frequently used for tocolysis. But, since these drugs exhibit some beta-1 activity as well, they may bring about pulmonary edema, myocardial ischemia, cardiac arrhythmia and others as side effects. A 29 year-old female with a triplet pregnancy had premature contraction at 26 weeks of gestation. High doses of IV ritodrine were given for tocolysis for 8 weeks until caesarean section. One hour after caesarean section at 35 weeks of gestation, she complained of dyspnea. Urinary output decreased and chest X-ray showed pulmonary edema. She was intubated and artificial ventilation with PEEP was performed in ICU. Echocardiogram showed left ventricular dilatation. ECG showed inverted T waves on all leads. We diagnosed her as suffering from acute heart failure, pulmonary edema and acute renal failure. Hemodialysis was performed for 6 hrs but PCWP was still 18 mmHg. So CVVH was added to hemodialysis. Five hrs after the start of CVVH, her symptoms gradually started to subside. Total fluid removal was 5.8 l over 16 hrs. Three days after admission she was extubated and five days later returned to her ward. We concluded that pulmonary edema, heart failure and renal failure were induced by the long-term high dose medication of ritodrine, resulting in volume overload and myocardial dysfunction.

UI MeSH Term Description Entries
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011272 Pregnancy, Multiple The condition of carrying two or more FETUSES simultaneously. Multiple Pregnancy,Multiple Pregnancies,Pregnancies, Multiple
D011654 Pulmonary Edema Excessive accumulation of extravascular fluid in the lung, an indication of a serious underlying disease or disorder. Pulmonary edema prevents efficient PULMONARY GAS EXCHANGE in the PULMONARY ALVEOLI, and can be life-threatening. Wet Lung,Edema, Pulmonary,Edemas, Pulmonary,Pulmonary Edemas,Lung, Wet,Lungs, Wet,Wet Lungs
D002585 Cesarean Section Extraction of the FETUS by means of abdominal HYSTEROTOMY. Abdominal Delivery,Delivery, Abdominal,C-Section (OB),Caesarean Section,Postcesarean Section,Abdominal Deliveries,C Section (OB),C-Sections (OB),Caesarean Sections,Cesarean Sections,Deliveries, Abdominal
D005260 Female Females
D006333 Heart Failure A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION. Cardiac Failure,Heart Decompensation,Congestive Heart Failure,Heart Failure, Congestive,Heart Failure, Left-Sided,Heart Failure, Right-Sided,Left-Sided Heart Failure,Myocardial Failure,Right-Sided Heart Failure,Decompensation, Heart,Heart Failure, Left Sided,Heart Failure, Right Sided,Left Sided Heart Failure,Right Sided Heart Failure
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208 Acute Disease Disease having a short and relatively severe course. Acute Diseases,Disease, Acute,Diseases, Acute
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012312 Ritodrine An adrenergic beta-2 agonist used to control PREMATURE LABOR. DU-21220,Pre-Par,Ritodrine Hydrochloride,Yutopar,DU 21220,DU21220,Hydrochloride, Ritodrine,Pre Par,PrePar

Related Publications

T Yamauchi, and K Kuzume, and S Hirata, and Y Yamauchi, and T Senda, and G Hamami, and T Arai
January 2004, Clinical and experimental obstetrics & gynecology,
T Yamauchi, and K Kuzume, and S Hirata, and Y Yamauchi, and T Senda, and G Hamami, and T Arai
January 1995, Masui. The Japanese journal of anesthesiology,
T Yamauchi, and K Kuzume, and S Hirata, and Y Yamauchi, and T Senda, and G Hamami, and T Arai
March 2007, International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics,
T Yamauchi, and K Kuzume, and S Hirata, and Y Yamauchi, and T Senda, and G Hamami, and T Arai
June 1988, New York state journal of medicine,
T Yamauchi, and K Kuzume, and S Hirata, and Y Yamauchi, and T Senda, and G Hamami, and T Arai
August 1988, American journal of obstetrics and gynecology,
T Yamauchi, and K Kuzume, and S Hirata, and Y Yamauchi, and T Senda, and G Hamami, and T Arai
July 1982, The Journal of reproductive medicine,
T Yamauchi, and K Kuzume, and S Hirata, and Y Yamauchi, and T Senda, and G Hamami, and T Arai
January 1982, The New England journal of medicine,
T Yamauchi, and K Kuzume, and S Hirata, and Y Yamauchi, and T Senda, and G Hamami, and T Arai
November 2009, European journal of obstetrics, gynecology, and reproductive biology,
T Yamauchi, and K Kuzume, and S Hirata, and Y Yamauchi, and T Senda, and G Hamami, and T Arai
June 2004, International journal of clinical pharmacology and therapeutics,
T Yamauchi, and K Kuzume, and S Hirata, and Y Yamauchi, and T Senda, and G Hamami, and T Arai
January 2020, PloS one,
Copied contents to your clipboard!