# Pulmonary Edema Following Nifedipine Use in Pregnancy: A Case Report

## TL;DR

A pregnant woman developed life-threatening pulmonary edema after using nifedipine as a tocolytic, highlighting a rare but serious risk.

## Contribution

Reports a rare adverse event of pulmonary edema linked to nifedipine use in pregnancy.

## Key findings

- Patient developed acute pulmonary edema shortly after starting nifedipine.
- Clinical improvement occurred after stopping nifedipine and administering furosemide.
- No evidence of cardiac or infectious causes was found.

## Abstract

Calcium channel blockers are generally considered safe for use during pregnancy. They have several indications, including second-line therapy for lowering blood pressure and tocolytic therapy. We present the case of a 24-year-old woman, G1P0, with a twin gestation at 22 weeks, who presented with acute respiratory distress. Her symptoms occurred shortly after starting nifedipine as tocolytic therapy. Investigations revealed signs of volume overload and pulmonary edema. Extensive cardiac and infectious workups were normal. Obstetrical ultrasound did not show any signs of ovarian hyperstimulation syndrome. Based on these findings, she was diagnosed with acute pulmonary edema following tocolytic therapy with oral nifedipine. Nifedipine was stopped, and intravenous furosemide was started, resulting in rapid clinical improvement. We are reporting this case to raise awareness of this rare but life-threatening adverse event associated with nifedipine use in pregnant patients.