TITLE:
When Status Asthmaticus Meets Severe Preeclampsia: A Critical Obstetric Scenario
AUTHORS:
Sêtondji Emmanuel Raymond Ahouangansi, Edwige Floriane Mouafo, Walamitien Cyrille Toure, Zolé Cédick Doh, Lossan Herman Kra, Aleke Koffi, Christian Danielle Chuekam, Kuate Christian Kadjé, Slim Chettaoui, Marc Kognombi, Takam Eleonore Sonia Fom, Giadjou Erika Vanessa Femtchou, Aude Djieumo, Patrick Ndjeundo
KEYWORDS:
Status Asthmaticus, Preeclampsia, HELLP Syndrome, Critical Care
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.15 No.10,
October
10,
2025
ABSTRACT: Introduction: Status asthmaticus during pregnancy is a rare but life-threatening respiratory emergency that can compromise both maternal and fetal outcomes. Its association with severe preeclampsia further complicates management and significantly increases the risk of multiple organ failures. Case Presentation: We report the case of a 39-year-old woman with a history of chronic asthma and hypertension, at 31 weeks of gestation, who was admitted to the intensive care unit for status asthmaticus complicated by a cardiopulmonary arrest that was successfully resuscitated. An emergency cesarean section was performed, delivering an extremely preterm infant weighing 800 g, who died on the fourth day of life. The maternal course was complicated by the development of HELLP syndrome with major hepatic cytolysis, thrombocytopenia, acute renal failure, and severe metabolic disorders, consistent with multiple organ failure. Management included lung-protective ventilation, correction of electrolyte and metabolic imbalances, strict blood pressure control, and close multidisciplinary monitoring. Extubation was achieved on day 4, and the patient showed progressive improvement, allowing transfer to a conventional ward on day 8 with full neurological recovery. Conclusion: The coexistence of status asthmaticus and severe preeclampsia in the third trimester represents an exceptional and dramatic obstetric emergency, associated with a high risk of multiorgan failure and perinatal mortality. Maternal outcome depends on rapid and coordinated management, including ventilatory support, strict blood pressure control, timely obstetric intervention, and multiorgan support. This case highlights the importance of a multidisciplinary approach and close follow-up of pregnant women with high-risk asthma.