Atosiban-induced acute pulmonary edema: A rare but severe complication of tocolysis
Background: Atosiban is commonly used to delay premature labor in pregnant women and is thought to have few side effects. Objectives: To report a case of acute pulmonary edema (APE) following administration of atosiban and conduct a systematic review to identify common characteristics and risk facto...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | Heliyon |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023030360 |
| _version_ | 1827937423895560192 |
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| author | Zuwei Yang Wei Wu Yi Yu Haiyan Liu |
| author_facet | Zuwei Yang Wei Wu Yi Yu Haiyan Liu |
| author_sort | Zuwei Yang |
| collection | DOAJ |
| description | Background: Atosiban is commonly used to delay premature labor in pregnant women and is thought to have few side effects. Objectives: To report a case of acute pulmonary edema (APE) following administration of atosiban and conduct a systematic review to identify common characteristics and risk factors of atosiban-associated APE. Methods: Searches were performed in Pubmed, Embase, and Web of Science using the keyword “Atosiban” combined with the terms “Pulmonary edema” or “Dyspnea” or “Hypoxia” on 9th July 2022. Only case reports of atosiban-associated APE were included without language restrictions. Data were extracted from the reports, and median, range, and percentages were calculated as applicable. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist for case reports. Results: Seven cases of atosiban-associated APE were included in the systematic review, including our case. APE occurred at a median gestational age of 32 + 6 weeks. Most patients were nulliparous (6/7, 85.7%) and were in multiple pregnancies (5/7, 71.4%). All patients were prescribed antenatal corticosteroids and tocolytics, with three (42.9%) receiving only atosiban and four (57.1%) receiving atosiban and other tocolytics. The median interval from starting atosiban administration to APE onset was about 40 h, and three patients (42.9%) showed symptoms 2–10 h after the end of atosiban treatment. Radiographic examinations (chest X-ray and/or computer tomography scan) confirmed APE in all patients and pleural effusion in four patients (57.1%). Five patients (71.4%) underwent emergency cesarean section, one patient (14.3%) with twin pregnancy had vaginal delivery with the help of suction cup and forceps, and another patient (14.3%) continued the pregnancy. All patients recovered well after administration of oxygen, diuresis, and other supportive therapy. Conclusion: Atosiban may cause acute pulmonary edema in patients with underlying risk factors. This complication remains rare, but caution during tocolytic treatment using atosiban is recommended. |
| first_indexed | 2024-03-13T08:25:25Z |
| format | Article |
| id | doaj.art-00e2929688aa461fb5a1b02db5a25338 |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-13T08:25:25Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Heliyon |
| spelling | doaj.art-00e2929688aa461fb5a1b02db5a253382023-05-31T04:45:41ZengElsevierHeliyon2405-84402023-05-0195e15829Atosiban-induced acute pulmonary edema: A rare but severe complication of tocolysisZuwei Yang0Wei Wu1Yi Yu2Haiyan Liu3Obstetrics and Gynecology Hospital, Fudan University, Shanghai, ChinaObstetrics and Gynecology Hospital, Fudan University, Shanghai, ChinaObstetrics and Gynecology Hospital, Fudan University, Shanghai, ChinaCorresponding author. 419, Fangxie Road, Huangpu District, Shanghai, China.; Obstetrics and Gynecology Hospital, Fudan University, Shanghai, ChinaBackground: Atosiban is commonly used to delay premature labor in pregnant women and is thought to have few side effects. Objectives: To report a case of acute pulmonary edema (APE) following administration of atosiban and conduct a systematic review to identify common characteristics and risk factors of atosiban-associated APE. Methods: Searches were performed in Pubmed, Embase, and Web of Science using the keyword “Atosiban” combined with the terms “Pulmonary edema” or “Dyspnea” or “Hypoxia” on 9th July 2022. Only case reports of atosiban-associated APE were included without language restrictions. Data were extracted from the reports, and median, range, and percentages were calculated as applicable. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist for case reports. Results: Seven cases of atosiban-associated APE were included in the systematic review, including our case. APE occurred at a median gestational age of 32 + 6 weeks. Most patients were nulliparous (6/7, 85.7%) and were in multiple pregnancies (5/7, 71.4%). All patients were prescribed antenatal corticosteroids and tocolytics, with three (42.9%) receiving only atosiban and four (57.1%) receiving atosiban and other tocolytics. The median interval from starting atosiban administration to APE onset was about 40 h, and three patients (42.9%) showed symptoms 2–10 h after the end of atosiban treatment. Radiographic examinations (chest X-ray and/or computer tomography scan) confirmed APE in all patients and pleural effusion in four patients (57.1%). Five patients (71.4%) underwent emergency cesarean section, one patient (14.3%) with twin pregnancy had vaginal delivery with the help of suction cup and forceps, and another patient (14.3%) continued the pregnancy. All patients recovered well after administration of oxygen, diuresis, and other supportive therapy. Conclusion: Atosiban may cause acute pulmonary edema in patients with underlying risk factors. This complication remains rare, but caution during tocolytic treatment using atosiban is recommended.http://www.sciencedirect.com/science/article/pii/S2405844023030360AtosibanAcute pulmonary edemaPregnancyPreterm birthTocolyticsHypoxia |
| spellingShingle | Zuwei Yang Wei Wu Yi Yu Haiyan Liu Atosiban-induced acute pulmonary edema: A rare but severe complication of tocolysis Heliyon Atosiban Acute pulmonary edema Pregnancy Preterm birth Tocolytics Hypoxia |
| title | Atosiban-induced acute pulmonary edema: A rare but severe complication of tocolysis |
| title_full | Atosiban-induced acute pulmonary edema: A rare but severe complication of tocolysis |
| title_fullStr | Atosiban-induced acute pulmonary edema: A rare but severe complication of tocolysis |
| title_full_unstemmed | Atosiban-induced acute pulmonary edema: A rare but severe complication of tocolysis |
| title_short | Atosiban-induced acute pulmonary edema: A rare but severe complication of tocolysis |
| title_sort | atosiban induced acute pulmonary edema a rare but severe complication of tocolysis |
| topic | Atosiban Acute pulmonary edema Pregnancy Preterm birth Tocolytics Hypoxia |
| url | http://www.sciencedirect.com/science/article/pii/S2405844023030360 |
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