Chest
SELECTED REPORTSPneumothorax and Pregnancy
Section snippets
Case 1
Chest pain and breathlessness of acute onset developed in a 26-year-old smoker who was in the first trimester of pregnancy. A moderate-sized pneumothorax resolved satisfactorily following aspiration. The previous obstetric history was of one normal pregnancy and delivery. An elective assisted delivery (forceps or ventouse extraction) was planned for 38 weeks, using an epidural anesthetic to avoid the mechanical stresses of labor. However, a failure to progress to the second stage of labor
Discussion
The development of spontaneous pneumothorax in an otherwise healthy young adult has relatively minor physiologic consequences unless a tension pneumothorax supervenes. During pregnancy, the functional residual capacity of the lungs is decreased, and the respiratory rate and tidal volume increase (due to raised progesterone levels) with a consequent 70% increase in alveolar ventilation and a 20% increase in oxygen consumption.1516 Oxygen consumption can increase by 50% during labor. Observation
References (21)
- et al.
Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement
Chest
(2001) - et al.
Thoracoscopic management of spontaneous pneumothorax during pregnancy
Int J Gynaecol Obstet
(2005) - et al.
Spontaneous pneumothorax complicating pregnancy: case report and review of the literature
J Emerg Med
(1989) - et al.
Post partum pneumothorax: two case reports and discussion
Int J Obstet Anesth
(2000) Respiratory disease in pregnancy
Med Clin North Am
(1977)- et al.
Pulmonary disease in pregnancy
Clin Chest Med
(1992) Subcutaneous emphysema, pneumomediastinum and pneumothorax in labor and delivery
Am J Obstet Gynecol
(1986)- et al.
Management of spontaneous pneumothorax during pregnancy: case report and review of the literature
Mayo Clin Proc
(1996) - et al.
Incidence of spontaneous pneumothorax in Olmsted County, Minnesota: 1950–1974
Am Rev Respir Dis
(1979) - et al.
Recurrence of primary spontaneous pneumothorax
Thorax
(1997)
Cited by (45)
Guidelines for management of patients with primary spontaneous pneumothorax
2023, Revue des Maladies RespiratoiresPrimary spontaneous pneumothorax during pregnancy: a case report and review of the literature
2022, Revista Espanola de Anestesiologia y ReanimacionChest Emergencies in Pregnant Patients
2022, Emergency Imaging of At-Risk Patients: General PrinciplesIntrapartum spontaneous pneumomediastinum with subcutaneous emphysema – Management and recommendations to prevent recurrence in future pregnancies
2020, International Journal of Obstetric AnesthesiaThoracic Surgery in the Pregnant Patient
2018, Thoracic Surgery ClinicsCitation Excerpt :Moreover, elective assisted delivery with an epidural or caesarean section under regional anesthesia is recommended to avoid the punctuated surges in intrathoracic pressure associated with spontaneous childbirth. The stakes involved at parturition, and the limited capacity for a reliable examination in cases of pneumothorax, make the deliberate path of elective delivery a safer option.7,8 Two types of secondary spontaneous pneumothorax in pregnancy have also been documented in the literature.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.