The safety and utility of pulmonary artery catheterization in severe preeclampsia and eclampsia

William M. Gilbert, Dena R. Towner, Nancy T Field, John Anthony

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

OBJECTIVE: The objective of this research was to study the safety and utility of pulmonary artery catheterization in the management of severe preeclampsia and eclampsia. STUDY DESIGN: In a retrospective chart review from January 1, 1995, through December 31, 1997, a total of 115 patients admitted to the obstetric intensive care unit at Groote Schuur Hospital were found to have required placement of a pulmonary artery catheter. From this population 100 maternal charts were examined for medical and pregnancy history, including indication for pulmonary artery catheter placement, hemodynamic readings, complications, and subsequent management. RESULTS: The initial indications for pulmonary artery catheter placement in cases of severe preeclampsia or eclampsia were renal failure in 53 cases (53%), pulmonary edema in 30 (30%), and eclampsia in 17 (17%). Subjective evaluation demonstrated that the pulmonary artery catheter was helpful in determining management in 93 cases (93%). There was a 4.0% complication rate, which included three venous thromboses and one case of cellulitis. Eleven patients required dialysis, and 3 women died. The mean (±SE) duration of catheter placement was 2.1 ± 0.1 days and the mean (±SE) intensive care unit and hospital stays were 3.4 ± 0.2 days and 11.4 ± 0.8 days, respectively. The pulmonary artery catheter measurements of pulmonary artery wedge pressure and central venous pressure were increased in the cases of pulmonary edema (21.0 ± 2.0 mm Hg and 9.6 ± 1.2 mm Hg, respectively) but were normal in the cases of renal failure and eclampsia. CONCLUSION: Despite significant maternal morbidity and mortality, pulmonary artery catheter use in cases of severe preeclampsia or eclampsia was subjectively beneficial in 93 of 100 cases (93%), with an acceptable complication rate (4.0%).

Original languageEnglish (US)
Pages (from-to)1397-1403
Number of pages7
JournalAmerican Journal of Obstetrics and Gynecology
Volume182
Issue number6
DOIs
StatePublished - 2000

Fingerprint

Swan-Ganz Catheterization
Eclampsia
Pre-Eclampsia
Pulmonary Artery
Catheters
Safety
Pulmonary Edema
Renal Insufficiency
Intensive Care Units
Reproductive History
Central Venous Pressure
Pulmonary Wedge Pressure
Cellulitis
Maternal Mortality
Venous Thrombosis
Obstetrics
Reading
Dialysis
Length of Stay
Hemodynamics

Keywords

  • Eclampsia
  • Preeclampsia
  • Pulmonary artery catheter

ASJC Scopus subject areas

  • Medicine(all)
  • Obstetrics and Gynecology

Cite this

The safety and utility of pulmonary artery catheterization in severe preeclampsia and eclampsia. / Gilbert, William M.; Towner, Dena R.; Field, Nancy T; Anthony, John.

In: American Journal of Obstetrics and Gynecology, Vol. 182, No. 6, 2000, p. 1397-1403.

Research output: Contribution to journalArticle

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