Diseases of the Respiratory System

Spontaneous pneumomediastinum and subcutaneous emphysema also known as Hamman's syndrome is a very rare complication of labor that is often related to the valsalva maneuver during the labor. In most case, Hamman's syndrome is a self-limiting condition, rarely complicated unless there are underlying respiratory diseases. Chest X-ray can be a useful early diagnostic technique in severe clinical presentation. We report an uneventful pregnancy in a primigravid parturient, which was complicated in the late second stage of labor by the development of subcutaneous emphysema, pneumomediastinum, and mild pneumothorax. Spontaneous recovery occurred after four days of conservative management. This condition shows the major interest of labor analgesia especially locoregional techniques.

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“…It is reported in a third of cases [11]. However, an isolated pneumothorax can occur in patients with predisposing lung disease.…”

Section: Discussionmentioning

confidence: 99%

“…Pneumothorax occurs due to a sudden rise in mediastinal pressure with rupture of the parietal mediastinal pleura. It is reported in a third of cases [ 11 ]. However, an isolated pneumothorax can occur in patients with predisposing lung disease.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Pneumomediastinum in Labor

Berdaï

Benlamkadem

Labib

et al. 2017

Case Reports in Obstetrics and Gynecology

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“…As pregnancy progresses, patients often complain of an increased respiratory rate due to progesterone stimulation of the central respiratory centre and altered sensitivity to CO 2 . 3 The gravid uterus reduces diaphragmatic movement and there is an increase in metabolic demand which can create the sensation of breathlessness. While in most cases this symptom is physiological, the clinician needs to maintain vigilance for the development of cardio-respiratory disease.…”

Section: Discussionmentioning

confidence: 99%

A Case of Breathlessness during Pregnancy: The Difficulty in Diagnosing Heart Failure

2012

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Summary: We present the case of a 33-year-old woman in her second pregnancy who was transferred to our unit following a one-month history of worsening fatigue and a three-day history of worsening symptoms of heart failure. Shortly after presentation she developed ventricular fibrillation and arrested. At an emergency caesarean section a placental abruption was noted and the baby was stillborn, unable to be resuscitated. The patient required a prolonged intensive and coronary care stay. Echocardiographic findings were consistent with dilated cardiomyopathy and as all investigations to ascertain a cause were negative she was diagnosed with peripartum cardiomyopathy. Her case highlights a potential fatal cause of breathlessness during pregnancy and the role of B-type natriuretic peptide to assist in the differential diagnosis of these cases.

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“…Pneumothorax accompanies about one-third of the cases of pneumomediastinum that occur in pregnancy, but it also occurs independently 8 . Co-existent pneumothorax may occur following abrupt elevation of mediastinal pressure with rupture of the mediastinal parietal pleura 9 .…”

Section: Discussionmentioning

confidence: 99%

“…Urgent relief is achieved by insertion of a 14 gauge intravenous cannula through the second intercostal space in the midclavicular line into the pleural space, followed by an appropriate thoracostomy tube and drainage system. Otherwise a pneumothorax is only drained if there are significant clinical symptoms, which are usually associated with more than 25% collapse of the lung 8 .…”

Section: Discussionmentioning

confidence: 99%

Post Partum Pneumomediastinum

2004

Anaesth Intensive Care

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A 19-year-old primigravida had a normal vaginal delivery after a 90-minute second stage of labour. Within two hours she complained of dyspnoea and was noticed to have unusual swelling of the face and neck. The diagnosis of subcutaneous emphysema was confirmed by chest X-ray and pneumomediastinum was also detected. Uneventful recovery over four days followed conservative management, administration of oxygen and use of simple analgesics.

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Diseases of the Respiratory System

Cited by 4 publications

References 252 publications

Spontaneous Pneumomediastinum in Labor

Spontaneous Pneumomediastinum in Labor

A Case of Breathlessness during Pregnancy: The Difficulty in Diagnosing Heart Failure

Post Partum Pneumomediastinum

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