Study of Maternal and Perinatal Outcomes in Pregnant Women with Respiratory Complications
Shashikala Karanth, Christy Vijay, C Jaya Sibi Mol, Nirupama Vijaykumar, Uma Devaraj, Chaitanya Harita Balakrishnan
ARDS, Asthma, Bronchitis, Pregnancy
Citation Information :
Karanth S, Vijay C, 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.
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.
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