Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 13 , ISSUE 4 ( July-August, 2021 ) > List of Articles

Original Article

Study of Maternal and Perinatal Outcomes in Pregnant Women with Respiratory Complications

C Jaya Sibi Mol, Nirupama Vijaykumar, Uma Devaraj, Chaitanya Harita Balakrishnan

Keywords : ARDS, Asthma, Bronchitis, Pregnancy

Citation Information : Mol CJ, Vijaykumar N, Devaraj U, Balakrishnan CH. Study of Maternal and Perinatal Outcomes in Pregnant Women with Respiratory Complications. J South Asian Feder Obs Gynae 2021; 13 (4):216-220.

DOI: 10.5005/jp-journals-10006-1936

License: CC BY-NC 4.0

Published Online: 20-11-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Introduction: The frequency and significance of acute and chronic respiratory disorders in pregnant women have increased in recent years. Clinicians must have an understanding of cardiopulmonary physiology to promptly recognize and treat pregnant women with respiratory conditions ranging from asthma to adult respiratory distress syndrome. Significant changes are seen in respiratory parameters as pregnancy progresses. Materials and methods: Our study was a retrospective record study, which analyzed various respiratory diseases in pregnancy and its effects on the perinatal outcome. Hospital documents of pregnant women who delivered in the institution during the years 2015–2019 was studied. Pregnant women with respiratory complications in pregnancy including new onset/or exacerbations of preexisting respiratory disease like asthma, acute bronchitis, acute respiratory distress syndrome (ARDS), and pneumonia were noted. Results: We identified 214 pregnant women with respiratory complications over a period of 5 years. The overall incidence was 2.3%; 94.4% were 20–35 years of age, and 82.2% delivered at term gestation (37–40 weeks). Respiratory complications like infective, restrictive, and obstructive lung diseases were seen. Bronchial asthma exacerbations in 155 (72%), respiratory tract infections (upper and lower respiratory tract infections) in 23 (10.7%), acute bronchitis in 16 (7.5%), ARDS in 8 (3.7%), pleural effusion in 3 (1.4%), tuberculosis in 2 (0.9%) and OSA in 1 (0.5%) were seen. A total of 3.2% had intensive care unit (ICU) admissions, and there was 1.4% maternal mortality. The following were observed in those with respiratory complications: a higher chance of preeclampsia in 31 (14.4%), increased rates of lower segment cesarian section (LSCS) in 99 (46.2%), intrauterine death (IUD) in 12 (5.6%), and poor appearance, pulse, grimmace, activity, respiration (APGAR) and neonatal intensive care unit (NICU) admissions of 99 (46.3%) women. Conclusion: Respiratory illnesses in pregnancy poses more risk to the mother than to the fetus. Close monitoring of the antenatal period with pulmonary function testing increases the chance of a good pregnancy outcome. Mothers with respiratory diseases should be screened antenatally as the chances of preterm and inrauterine growth restriction (IUGR) are high in the fetus.

  1. Frye D, Clark SL, Piacenza D, et al. Pulmonary complications in pregnancy. J Perinat Neonatal Nurs 2011;25(3):235–244. DOI: 10.1097/JPN.0b013e3182230e25.
  2. Yannone ME, McCurdy JR, Goldfien A. Plasma progesterone levels in normal pregnancy, labor, and the puerperium. Am J Obstet Gynecol 1968;101(8):1058–1061. DOI: 10.1016/0002-9378(68)90348-7.
  3. Cugell DW, Frank NR, Gaensler EA, et al. Pulmonary function in pregnancy. I. Serial observations in normal women. Am Rev Tuberc 1953;67(5):568–597. DOI: 10.1164/art.1953.67.5.568.
  4. Norwitz ER, Robinson JN, Malone FD. Pregnancy-induced physiologic alterations. Critical care obstetrics. 2010 Sep 3;5:30–52.
  5. Jaffe RB, Josimovich JB. Endocrine physiology of pregnancy. Obstetrics and Gynecology. Hagerstown, MD: Harper & Row. 1977:286–298.
  6. Weinberger SE, Weiss ST, Cohen WR, et al. Pregnancy and the lung. Am Rev Respir Dis 1980;121(3):559–581. DOI: 10.1164/arrd.1980.121.3.559.
  7. Gaga M, Zervas E. Breathing for two: pregnancy, asthma and respiratory failure. Eur Respir Rev 2014;23(131):5–7. DOI: 10.1183/09059180.00000914.
  8. Murphy VE, Schatz M. Asthma in pregnancy: a hit for two. Eur Respir Rev 2014;23(131):64–68. DOI: 10.1183/09059180.00008313.
  9. Kwon H, Belanger K, Bracken MB. Asthma prevalence among pregnant and childbearing-aged women in the United States: estimates from national health surveys. Ann Epidemiol 2003;13(5):317–324. DOI: 10.1016/s1047-2797(03)00008-5.
  10. Jana N, Vasishta K, Jindal SK, et al. Perinatal outcome in pregnancies complicated by pulmonary tuberculosis. Int J Gynecol Obstet 1994;44(2):119–124. DOI: 10.1016/0020-7292(94)90064-7.
  11. Getahun D, Ananth CV, Oyelese Y, et al. Acute and chronic respiratory diseases in pregnancy: associations with spontaneous premature rupture of membranes. J Matern Fetal Neonatal Med 2007;20(9):669–675. DOI: 10.1080/14767050701516063.
  12. Schatz M, Zeiger RS, Hoffman CP, et al. Perinatal outcomes in the pregnancies of asthmatic women: a prospective controlled analysis. Obstet Gynecol Surv 1995;50(11):763–764. DOI: 10.1164/ajrccm/151.4.1170.
  13. Enriquez R, Griffin MR, Carroll KN, et al. Effect of maternal asthma and asthma control on pregnancy and perinatal outcomes. J Allergy Clin Immunol 2007;120(3):625–630. DOI: 10.1016/j.jaci.2007.05.044.
  14. Beckmann CA. The effects of asthma on pregnancy and perinatal outcomes. J Asthma 2003;40(2):171–180. DOI: 10.1081/jas-120017988.
  15. Murphy VE, Clifton VL, Gibson PG. Asthma exacerbations during pregnancy: Incidence and association with adverse pregnancy outcomes. Thorax 2006;61(2):169–176. DOI: 10.1136/thx.2005.049718.
  16. Lapinsky SE, Kruczynski K, Slutsky AS. Critical care in the pregnant patient. Am J Respir Crit Care Med 1995;152(2):427–455. DOI: 10.1164/ajrccm.152.2.7633692.
  17. Hartert TV, Neuzil KM, Shintani AK, et al. Maternal morbidity and perinatal outcomes among pregnant women with respiratory hospitalizations during influenza season. Am J Obstet Gynecol 2003;189(6):1705–1712. DOI: 10.1016/s0002-9378(03)00857-3.
  18. Wong SF, Chow KM, Leung TN, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. Am J Obstet Gynecol 2004;191(1):292–297. DOI: 10.1016/j.ajog.2003.11.019.
  19. Lapinsky SE, Kruczynski K, Seaward GR, et al. Critical care management of the obstetric patient. Can J Anaesth 1997;44(3):325–329. DOI: 10.1007/BF03015374.
  20. Panchal S, Arria AM, Harris AP. Intensive care utilization during hospital admission for delivery: prevalence, risk factors, and outcomes in a statewide population. Anesthesiology 2000;92(6):1537–1544. DOI: 10.1097/00000542-200006000-00009.
  21. Madinger NE, Greenspoon JS, Ellrodt AG. Pneumonia during pregnancy: has modern technology improved maternal and fetal outcome? Am J Obstet Gynecol 1989;161(3):657–662. DOI: 10.1016/0002-9378(89)90373-6.
  22. Stiller-Timor L, Levy A, Holcberg G, et al. Upper respiratory tract infection during pregnancy: Is it associated with adverse perinatal outcome? Am J Perinatol 2010;27(8):619–623. DOI: 10.1055/s-0030-1249364.
  23. Figueroa-Damian R, Arredondo-Garcia JL. Pregnancy and tuberculosis: Influence of treatment on perinatal outcome. Am J Perinatol 1998;15(5):303–306. DOI: 10.1055/s-2007-993948.
  24. Getahun D, Ananth CV, Peltier MR, et al. Acute and chronic respiratory diseases in pregnancy: associations with placental abruption. Am J Obstet Gynecol 2006;195(4):1180–1184. DOI: 10.1016/j.ajog.2006.07.027.
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