Respiratory complications of pregnancy
Respiratory complications of pregnancy
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DOI：
10.1097/00006254-200201000-00022
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发表时间：
2002-01-01
影响因子：
6.2
通讯作者：
Szerlip, HM
中科院分区：
文献类型：
--
作者：
Ie, S;Rubio, ER;Szerlip, HM
孕妇易患各种呼吸道并发症。当一个怀孕的病人出现异常的胸部X光或肺部疾病时，对妊娠病理生理的理解将指导临床医生做出诊断。怀孕会给女人的身体带来很多变化。其中一个更有趣的是T辅助细胞的减少，导致相对免疫抑制的状态。尽管如此，感染性肺炎的患病率在怀孕期间并没有增加。然而，肺炎的并发症在怀孕的宿主中增加。最显著的是与流感感染有关的死亡率和球孢子菌病传播风险的增加。其他生理变化使孕妇易患某些疾病。与妊娠相关的高凝状态导致血栓栓塞性疾病的发生率显著增加。虽然罕见，但妊娠也与其他栓塞现象有关，包括羊水栓塞、空气栓塞和滋养层栓塞。由于怀孕期间血管内容量和心输出量增加，患有基础结构性心脏病的女性经常会首次出现或病情加重。二尖瓣狭窄尤其如此。围产期心肌病也可能发生，对于大多数患者来说，心脏终身受损。最后，虽然不常见，但淋巴管平滑肌瘤病通常会在妊娠期间出现或加重。患有这种疾病的患者需要咨询与怀孕相关的风险增加。本文综述了与妊娠相关的各种呼吸系统并发症。
The pregnant woman is susceptible to a variety of respiratory complications. When a pregnant patient presents with an abnormal chest x-ray or a pulmonary complaint, an understanding of the pathophysiology of pregnancy will guide the clinician in establishing a diagnosis. Pregnancy brings about many changes to a woman's body. One of the more intriguing is a decrease in the T helper cells, resulting in a state of relative immunosuppression. Despite this, the prevalence of infectious pneumonia is not increased in pregnancy. Complications from pneumonia, however, are increased in the pregnant host. Most notably are increases in both mortality related to influenza infection and the risk for dissemination of coccidioidomycosis.Other physiologic changes predispose the pregnant woman to certain disease processes. Hypercoagulability associated with pregnancy results in a marked increase in the incidence of thromboembolic disease. Although rare, pregnancy is also associated with other embolic phenomena including amniotic fluid embolism, air embolism, and trophoblastic embolism. Because of the increases in intravascular volume and cardiac output that occur in pregnancy, women with underlying structural heart disease will frequently present for the first time or have an exacerbation of their disease. This is especially true of mitral stenosis. Peripartum cardiomyopathy also can occur, and for the majority of patients, the heart remains damaged for life. Finally, although uncommon, lymphangioleiomyomatosis will often present or become exacerbated during pregnancy. Patients with this disorder need to be counseled concerning the increased risk associated with pregnancy. This paper reviews the various respiratory complications associated with pregnancy.