A 32 weeks pregnant female with preterm contractions treated with tocolytic agents. She fuher developed pulmonary edema. Which of the following tocolytic must have caused pulmonary edema in this patient?
The infusion of beta-agonists (Ritodrine) has resulted in frequent and at times, serious and fatal side effects. Pulmonary edema is a special concern. Because beta-agonists cause retention of sodium and water, with time--usually 24 to 48 hours, these can cause volume overload. The cause of pulmonary edema is multifactorial, and risk factors include: Tocolytic therapy with beta-agonists Multifetal gestation Concurrent coicosteroid therapy Tocolysis for more than 24 hours Large intravenous crystalloid volume infusion Ref: Cunningham F.G., Leveno K.J., Bloom S.L., Hauth J.C., Rouse D.J., Spong C.Y. (2010). Chapter 36. Preterm Bih. In F.G. Cunningham, K.J. Leveno, S.L. Bloom, J.C. Hauth, D.J. Rouse, C.Y. Spong (Eds), Williams Obstetrics, 23e.
Ritodrine
Nifedipine
Indomethacin
Atosiban