Respiratory Failure and Mechanical Ventilation in the Pregnant Patient

Schwaiberger, David; Karcz, Marcin; Menk, Mario; Papadakos, Peter J.; Dantoni, Susan E.

doi:10.1016/j.ccc.2015.08.001

Cited by 40 publications

(44 citation statements)

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“…[7][8][9][10][11] Literature says that rise in hydrostatic pressure from hypertension and alterations in capillary membrane permeability results in pulmonary edema in around 3% of women with preeclampsia/ eclampsia, typically after delivery, when plasma oncotic pressure is at its lowest. 7,[14][15][16] Similar to this, maximum women (70%) presented post-partum with shortness of breath in the present study too, majority within first 24 hours.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7][8][9][10][11][12] On further analysis, most of them were un-booked with no prior antenatal supervision, belonging to lower socioeconomic background. Maximum females thus came as referral cases from peripheral centers drained by our hospital, following lack of awareness about the entity or unsatisfactory and inadequate treatment practices by less skilled practitioners available there.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9][10][11][12][13] It may be further ascribed to poverty, illiteracy, malnutrition, early age at marriage and subsequently initial conception. This legion of women is often oblivious of the essential and emergent obstetric services, need for prenatal care, symptoms and concept of high risk pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…Though a few studies are available depicting outcome of ARDS in pregnancy, the paucity of research articles scrutinizing the causes, and outcome of dyspnea in pregnancy remains the strongest forte of this study. [7][8][9][10][11][12][13] In the course of the study period of one year, 1.9% of the total admissions (17002) in obstetrics and gynecology department presented with dyspnea. This was quite a high incidence.…”

Section: Discussionmentioning

confidence: 99%

“…6 Due to varied etiology and lack of sufficient research on such patients, especially in LMIC countries, optimal management of women presenting with dyspnea in pregnancy remains elusive. [1][2][3][4][5][6][7][8][9][10][11] Keeping this in mind, the present research is conceived to find out the etiology and outcome of patients presenting with dyspnea in obstetric emergency. This would be in turn instrumental in formulating institutional guidelines for management of such women, which could be widely applied across nation.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Managing dyspnea in pregnancy-an errand uphill: an experience from the critical care obstetric unit of a tertiary care facility in India

Marwah

Suri

Mittal

2017

Int J Reprod Contracept Obstet Gynecol

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Background: The occurrence of dyspnea in a gravid woman induces the query in the treating obstetrician regarding its root cause being either underlying or new cardiac or pulmonary disease, or due to the pregnancy itself. Attainment to this conclusion requires grasp of the cardiopulmonary changes befalling during normal pregnancy, as well as detection of the ailment of dyspnea during antenatal period. Objective of present study was to find out the incidence and feto-maternal outcome of patients presenting with dyspnea in pregnancy and puerperium.Methods: This study was conducted in Department of Obstetrics and Gynaecology in Vardhaman Mahavir Medical College and Safdarjung hospital over a period of one year, wherein review of all women who had presented with a diagnosis of dyspnea in pregnancy and puerperium, and admitted and treated in the Critical care obstetric unit of the department was done. Thorough evaluation was done and case files were exhaustively reviewed, data was anonymously extracted, and outcomes analyzed. All causes of mortality were also recorded. The primary outcome was incidence of dyspnea in pregnancy. Secondary outcomes measured were socio-demographic variables, timing of presentation-antepartum=first trimester, second trimester, third trimester/postpartum<48 hours, 3-7 days,>7 days, causative factors for dyspnea, any other obstetric complications, mode of delivery, fetal outcome (fetus weight, Apgar score, need for NICU admission), need for ICU/HDU admission, duration and course in the hospital, mortality, and cause of death in case of mortality. Data recording was done on a predesigned proforma and deciphered at the end of study and analyzed.Results: Incidence of dyspnea was 1.97% of all admissions. Pulmonary edema following hypertensive disorders of pregnancy, was the leading cause. 28.5 % women succumbed to their illness. Majority were preterm births (88/112), requiring NICU admission.Conclusions: The clinician should be able to determine the underlying cause of dyspnea, differentiating it from physiologic progesterone-induced hyperventilation. Strategy of expeditious delivery during the third trimester is often warranted after weighing fetal outcome and maternal risk in such women.

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