Breathlessness in the absence of an underlying pathological reason is common in pregnancy, but serious causes should be excluded depending on symptoms. Pregnancy is associated with many anatomical and physiologic changes that affect the presentation and management of various illnesses. This article is presenting several respiratory issues that one may encounter in the gravid patient including asthma, pneumonia, tuberculosis and acute respiratory distress in pregnancy. Approach to dyspnoea in pregnancy.Pulmonary diseases are the major indirect causes of maternal death. Significant physical changes occur in pregnancy to meet metabolic needs of both mother and growing fetus. Anatomical changes like hormonal changes especially estrogen is responsible for producing tissue edema, capillary congestion and hyperplasia of mucous gland. Enlarging uterus with hormonal effects produce changes in thoracic cage. Those altogether causes respiratory disorder in pregnancy.
Asthma affects about 7% of women of child-bearing age. Pregnancy is a heterogeneous immune state affecting the course of asthma. It is important to educate women to continue inhaled preventer therapy to reduce the risk of attacks. Respiratory infections are associated with a higher morbidity in pregnancy and should be treated aggressively. Treatment of acute severe asthma in pregnancy is almost similar to non-pregnant women.
Tuberculosis and dyspnea
TB is one of the leading causes of mortality in reproductive age women. Risk factors of Tuberculosis(TB) in pregnancy include positive family history or patients past history. Treatment of TB in pregnancy is similar to that administered to non-pregnant counterparts.
Shortness of breath is a common complaint in pregnancy, affecting 60% to 70% of women with no previous history of cardiac or pulmonary disease.Patient present with dyspnea’s clinical presentation is similar to that of non-pregnant women but risk of respiratory failure and empyema is high. Thus patient needs to be educated about respiratory disease in pregnancy medication.
Now with the modern antibiotic drugs are available the maternal risk of bacterial pneumonia in pregnancy is trivial. The risks are to the fetus where the associated high fever and toxicity may cause any adverse situation. As it is one of the important causes of indirect maternal mortality. Patient suspected with pneumonia should get a chest radiograph with abdominal shield. Fever should be therefore treated aggressively.
Influenza is most common viral infection in pregnancy. Resulting in increased morbidity and mortality. Increased risk of preterm delivery low-birth weight infant, severe pneumonia and maternal death have been observed.
The presence of pulmonary hypertension is associated with a high risk of death in pregnancy. Although pregnant patients with pulmonary disorders are often treated with medications commonly used in the non-gravid patient, the effects of many of these medications on pregnancy and foetal development are unknown. More research of the effects of new therapies are needed in pregnant women to ensure patient access to the most effective treatments, and to provide knowledge of the risks of such treatments.Its treatment includes prevention and supportive care. And needs to go through serious medications for respiratory disorders in pregnancy.