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Pre-eclampsia pulmonary oedema — FRCA Final MCQ

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HardObstetric AnaesthesiaPre-eclampsia pulmonary oedemaFRCA Final

A 33-year-old woman with pre-eclampsia on magnesium sulphate develops pulmonary oedema in recovery after caesarean section. SpO2 is 90% on 15 L/min oxygen, blood pressure is 174/112 mmHg, urine output is 15 ml/hour, and chest auscultation reveals widespread crackles. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Give oxygen, restrict fluids, treat hypertension and use intravenous diuretic

Pulmonary oedema in severe pre-eclampsia requires oxygenation support, fluid restriction, careful diuresis and prompt blood-pressure control. Oliguria should not automatically trigger fluid boluses in this context because capillary leak and cardiac dysfunction are common. Calcium is reserved for magnesium toxicity with loss of reflexes or respiratory depression, not for hypertension-related pulmonary oedema. Ergometrine may worsen hypertension.

Reference: NICE NG133 hypertension in pregnancy; OAA obstetric anaesthesia guidance