Acute pulmonary edema secondary to magnesium sulfate tocolysis in twin pregnancy: a case report

Objectives: Acute pulmonary edema during pregnancy is a rare but serious complication, particularly in association with magnesium sulfate therapy for tocolysis. This case report describes a 27-year-old woman with a twin pregnancy who developed acute pulmonary edema after 3 days of magnesium sulfate treatment. Case presentation: The patient presented with chest tightness, dyspnea, and respiratory distress. Immediate clinical intervention included discontinuation of magnesium sulfate and administration of furosemide to reduce cardiac preload. She was managed with diuretics, sedatives, and inotropic agents. Both infants were delivered successfully, and the patient recovered after supportive care in the intensive care unit. Conclusions: This case highlights the potential risks of fluid retention and the importance of monitoring maternal fluid status during tocolysis. It also emphasizes the need for vigilance in managing twin pregnancies with magnesium sulfate therapy to prevent serious complications such as pulmonary edema. Clinicians should be aware of this rare but potentially life-threatening complication and ensure that fluid balance is carefully monitored in such cases.