Peripartum Respiratory Failure in a Patient With Severe Preeclampsia

Preeclampsia is a major hypertensive disorder of pregnancy associated with increased maternal, fetal, and neonatal risks. Acute respiratory failure, though rare, is a severe complication that may arise due to preeclampsia or unrelated medical conditions. We present a case of a 23-year-old primiparous woman admitted to our Emergency Department with gestational hypertension during her third trimester. She was hospitalized for blood pressure regulation and preeclampsia screening, which included urine protein analysis, blood tests for liver and kidney function, and fetal monitoring through cardiotocography. Laboratory tests revealed albuminuria but no indicators of severe preeclampsia. On the fourth day of hospitalization, despite antihypertensive treatment, the patient's blood pressure remained elevated, and she developed severe headaches. An emergency caesarean section was performed. During the procedure, she experienced severe bronchospasm, causing transient oxygen desaturation. Despite initial improvement, persistent hypoxemia required increased oxygen administration. Imaging and cardiological evaluations ruled out major complications, and she was admitted to the intensive care unit for eight days. Following a 14-day hospitalization, the patient was discharged in stable hemodynamic and respiratory condition, with follow-up instructions for cardiology and pulmonology assessment. Severe preeclampsia can lead to life-threatening complications, including acute respiratory failure. Prompt differential diagnosis and timely intervention are crucial to improving maternal outcomes.