Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Presentation Icons

Additional registration fee required

Faculty have requested this content not be shared outside of the session

CME Credit Offered

Abstract Award

Recording available 2/16-5/2

AIUM Credit

Foundation Awardee

Poster Icons

Abstract Award

Foundation Awardee

Poster Session 4

Category: Hypertension

Poster Session 4

(1292) Antepartum vs Postpartum Pulmonary Edema in Preeclampsia: Echocardiographic findings and Maternal Outcomes

Thursday, February 12, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

WA

Wissam Akkary, MD

Maternal-Fetal Medicine Fellow
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States

Coauthor(s)

Ahmed Zaki Moustafa, MD, MS (he/him/his)

Assistant Professor
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
University of Texas - Houston, Texas, United States
Megan C. Shepherd, MD (she/her/hers)

Assistant Professor
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
PT

Poyee Tung, MD

Department of Cardiology, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Zakaria Doughan, MD

Research Assistant
Department of Obstetrics and Gynecology, McGovern Medical School at UT Health, Houston
Houston, Texas, United States
Yossi Bart, MD

MFM fellow
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States
Baha M. Sibai, MD

Professor
Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, McGovern Medical School at UTHealth Houston
Houston, Texas, United States

Objective:
Echocardiographic evaluation in preeclampsia complicated by pulmonary edema may help in establishing pathophysiology and guide management. However, there is limited data comparing findings between antepartum versus postpartum onset of pulmonary edema. Our objective is to compare echocardiographic findings and maternal outcomes between antepartum and postpartum pulmonary edema in patients with preeclampsia. 

Study Design:
This is a retrospective cohort study of patients with preeclampsia complicated by pulmonary edema at a single quaternary center between 2016–2023. Pulmonary edema was defined by clinical and radiographic criteria. Echocardiographic parameters assessing both systolic and diastolic function were compared according to timing of onset of pulmonary edema: antepartum vs postpartum. Data were abstracted by chart review, and ECHO findings were reviewed by a cardiologist. The primary outcome was echocardiographic findings. The secondary outcome was a composite maternal adverse outcome (CMAO), including ICU admission, need for respiratory support, and death.

Results:
A total of 71 patients were studied. Pulmonary edema was diagnosed in 30 patients (41.7%) in antepartum period and in 42 (58.3%) postpartum. Antepartum cases were more likely to have chronic hypertension, deliver at an earlier gestational age, undergo cesarean delivery, and have a lower fluid balance at delivery (Table 1). Following adjustment for chronic hypertension, CMAO was significantly higher in the postpartum group (aOR 3.93; 95th CI 1.12- 13.85). Table 2 compares ECHO findings between the 2 groups. Postpartum pulmonary edema was associated with worse systolic function, including lower fractional shortening (27.7% vs. 32.3%, p=0.03) and lower stroke volume (63.0 mL vs. 76.0 mL, p</span><0.01).

Conclusion:
In preeclampsia complicated by pulmonary edema, postpartum onset was associated with worse systolic function and a higher CMAO rate compared to antepartum onset. These findings suggest distinct pathophysiologic mechanisms may underlie pulmonary edema in preeclampsia, highlighting the need for targeted management strategies.