Case Report on Pre-Eclampsia with Severe Features, Peri Partum Cardiomyopathy

Introduction: Pre-eclampsia with severe features is a life-threatening multi systemic disease with reported worldwide incidence of 5-14% with the incidence being 8-10% in India. CASE REPORT: Mrs. XX, 21 years old primigravida presented as an emergency case in labor room at 40 weeks and 2 days gestation with severe pre eclamptic symptoms. On examination GCS- E2V2M4, Pulse- 140/min, BP- 200/120mmHg, RR- 40/min, grade 3 edema with SpO2 60% in room air. Systemic examination of chest revealed bilateral lung crepitations with fetal tachycardia. Laboratory findings were suggestive of incomplete HELLP syndrome and arterial blood gas analysis revealed respiratory acidosis. Patient was immediately intubated and shifted to Intensive Care Unit. After stabilization with diuretics patient was posted for emergency LSCS in view of fetal distress and pulmonary edema. On postoperative day 1 patient continued to be symptomatic and an echocardiography revealed cardiomyopathy with ejection fraction of 39%. Patient was managed by a multi-disciplinary team approach. Subsequently patient improved and was discharged on post-operative day 11 with good maternal and fetal outcome. DISCUSSION: Pre-eclampsia is multisystemic major complication of Hypertensive disease of pregnancy. Acute pulmonary edema signifies severe disease and is one of the frequent causes of intensive care unit admission, maternal morbidity and mortality. Conclusion: Appropriate antenatal management, early detection of pre monitory symptoms, timely intervention and awareness in peripheral health workers for early referral are the key factors to prevent acute and subsequent long-term complications related to pre eclamptic toxemia.