Clinical features and outcomes in patients with pulmonary complications during pregnancy and peripartum.
Yeji HanJin-Hwa LeeJung Hyun ChangSung Shine ShimYoo Kyung KimYon Ju RyuPublished in: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians (2018)
Introduction: The aim of this study was to investigate clinical features and identify maternal factors contributing to prognosis in women with pulmonary complications during pregnancy and the peripartum period.Materials and methods: Following a retrospective review of clinical data and radiographic findings between January 2006 and January 2016, 126 women diagnosed with pulmonary complications during pregnancy (N = 79) and peripartum within the first 4 weeks after delivery (N = 47) were enrolled in this study.Results: Of the 126 patients, 113 (89.7%) required hospitalization. The median age was 32 years, and the percentage of primiparous women was 49.2%. The most common respiratory complaint was dyspnea, followed by cough and fever. Pneumonia developed in 50 patients (39.6%), pulmonary edema in 31 (24.6%), pleural effusion in 28 (22.2%), active pulmonary tuberculosis in 13 (10.3%), and asthma exacerbation in 4 (3.1%). Among the 79 antenatal patients with pulmonary complications, 31 (39.2%) experienced pregnancy-related complications, 21 (26.6%) had an emergency C-section, and 29 (36.7%) had an adverse fetal outcome. Eleven patients (8.7%) developed acute respiratory failure requiring mechanical ventilation, and the overall mortality was 1.6% (2/126) with no pulmonary complication-related deaths. Multiple regression analysis revealed that presence of pregnancy-related complications and younger fetal gestational age at the diagnosis were independent predictive factors for adverse fetal outcomes.Discussion: Pulmonary complications during pregnancy and the peripartum period resulted in poor outcomes, and the risk of adverse fetal outcomes was high, particularly in patients with pregnancy-related complications and younger gestational age at the diagnosis.
Keyphrases
- pulmonary hypertension
- gestational age
- respiratory failure
- end stage renal disease
- preterm birth
- risk factors
- mechanical ventilation
- ejection fraction
- newly diagnosed
- birth weight
- chronic kidney disease
- pregnancy outcomes
- pulmonary tuberculosis
- prognostic factors
- peritoneal dialysis
- emergency department
- pregnant women
- chronic obstructive pulmonary disease
- intensive care unit
- cardiovascular disease
- mycobacterium tuberculosis
- machine learning
- extracorporeal membrane oxygenation
- adipose tissue
- patient reported outcomes
- public health
- electronic health record
- single cell
- liver failure
- emergency medical