Medical Disorders in Pregnancy · NEET PG Preparation Obstetrics & Gynaecology
A 32-year-old pregnant woman with known rheumatic mitral stenosis (NYHA Class II) at 30 weeks of gestation presents with acute onset shortness of bre…
Practice question from Medical Disorders in Pregnancy (NEET PG Preparation Obstetrics & Gynaecology), with the correct answer and a step-by-step solution.
medium · MCQ · Q-05846C
A 32-year-old pregnant woman with known rheumatic mitral stenosis (NYHA Class II) at 30 weeks of gestation presents with acute onset shortness of breath, orthopnea, and pink frothy sputum following a bout of strenuous physical activity. On examination, she is tachycardic, tachypneic, and bilateral basal crackles are audible. What is the immediate first-line medical management for acute pulmonary edema in this patient?
- A.Intravenous beta-blockers and oral digoxin
- B.Supplemental oxygen, upright posture, and intravenous loop diuretics (furosemide)Correct answer
- C.Emergency percutaneous balloon mitral valvotomy
- D.Intravenous fluid bolus and oxytocin infusion
Solution
Acute pulmonary edema in a pregnant woman with mitral stenosis represents a cardiac emergency precipitated by increased hemodynamic load. Initial medical management mirrors non-pregnant protocols: supplemental oxygen, sitting upright to decrease venous return, and intravenous loop diuretics (such as furosemide) to reduce preload. Fluid boluses would exacerbate pulmonary congestion.
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