Which of the following is a typical cause of hydrostatic pulmonary edema in pregnancy?

• A. Systolic dysfunction (cardiomyopathy)
• B. Infection
• C. DIC
• D. Amniotic fluid embolism

Answer: (A)

Hydrostatic pulmonary edema in pregnancy mainly arises from left-sided heart failure due to systolic dysfunction. When the heart’s contractility is impaired, the left ventricle cannot eject effectively, raising left atrial and pulmonary venous pressures. That increased hydrostatic pressure pushes fluid from the capillaries into the interstitial and alveolar spaces, causing edema. Pregnancy can precipitate cardiomyopathy (peripartum cardiomyopathy), making systolic dysfunction a classic mechanism.

Infection can lead to edema through inflammatory pathways and capillary leak (noncardiogenic edema), not the hydrostatic mechanism. DIC and amniotic fluid embolism involve shock and coagulopathy; edema may occur but is not the typical hydrostatic type.