Pneumonia in pregnancy.
Pneumonia in pregnancy.
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DOI：
10.1097/01.ccm.0000182483.24836.66
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发表时间：
2005-10-01
影响因子：
8.8
通讯作者：
Soper, David E
中科院分区：
文献类型：
--
作者：
Goodnight, William H;Soper, David E
目的：从历史上看，与非妊娠妇女相比，妊娠期肺炎与发病率和死亡率增加有关。本文的目的是回顾目前的文献描述肺炎在怀孕。本次审查将确定产妇的危险因素，潜在的并发症，产前结果与肺炎，并描述了当代管理的各种原因的肺炎在pregnancy.RESULTS：并存的孕产妇疾病，包括哮喘和贫血，增加感染肺炎的风险在怀孕。妊娠期肺炎对新生儿的影响包括低出生体重和早产风险增加，严重的产妇并发症包括呼吸衰竭。社区获得性肺炎是妊娠期最常见的肺炎形式，其中肺炎链球菌、流感嗜血杆菌和肺炎支原体占大多数已鉴定的细菌微生物。β-内酰胺类和大环内酯类抗生素在妊娠期被认为是安全的，对大多数妊娠期社区获得性肺炎有效。病毒性呼吸道感染，包括水痘、流感和严重急性呼吸道综合征，可能与母亲肺炎有关。目前的抗病毒和呼吸治疗可以降低病毒性肺炎的孕产妇发病率和死亡率。流感疫苗接种可以减少流感季节孕妇呼吸道住院的患病率。肺孢子虫肺炎继续给免疫功能低下的人群带来重大的孕产妇风险。预防和治疗肺孢子虫肺炎与甲氧苄啶/磺胺甲恶唑是有效的，在降低这种risk.Conclusions：及时诊断和治疗与当代的抗菌药物治疗和重症监护病房管理的呼吸道损害，降低了孕产妇的发病率和死亡率，由于肺炎在怀孕。在高危人群中接种疫苗预防可能会降低孕妇肺炎的患病率和严重程度。
OBJECTIVE: Historically, pneumonia during pregnancy has been associated with increased morbidity and mortality compared with nonpregnant women. The goal of this article is to review current literature describing pneumonia in pregnancy. This review will identify maternal risk factors, potential complications, and prenatal outcomes associated with pneumonia and describe the contemporary management of the varied causes of pneumonia in pregnancy.RESULTS: Coexisting maternal disease, including asthma and anemia, increase the risk of contracting pneumonia in pregnancy. Neonatal effects of pneumonia in pregnancy include low birth weight and increased risk of preterm birth, and serious maternal complications include respiratory failure. Community-acquired pneumonia is the most common form of pneumonia in pregnancy, with Streptococcus pneumoniae, Haemophilus influenzae, and Mycoplasma pneumoniae accounting for most identified bacterial organisms. Beta-lactam and macrolide antibiotics are considered safe in pregnancy and are effective for most community-acquired pneumonia in pregnancy. Viral respiratory infections, including varicella, influenza, and severe acute respiratory syndrome, can be associated with maternal pneumonia. Current antiviral and respiratory therapies can reduce maternal morbidity and mortality from viral pneumonia. Influenza vaccination can reduce the prevalence of respiratory hospitalizations among pregnant women during influenza season. Pneumocystis pneumonia continues to carry significant maternal risk to an immunocompromised population. Prevention and treatment of Pneumocystis pneumonia with trimethoprim/sulfamethoxazole is effective in reducing this risk.CONCLUSIONS: Prompt diagnosis and treatment with contemporary antimicrobial therapy and intensive care unit management of respiratory compromise has reduced the maternal morbidity and mortality due to pneumonia in pregnancy. Prevention with vaccination in at-risk populations may reduce the prevalence and severity of pneumonia in pregnant women.