Beneficial Effect of Delivery in a Patient with Adult Respiratory Distress Syndrome

Pregnancy Complicated by Ludwig's Angina Requiring Delivery

“…The physiological changes associated with this preterm delivery may have resulted in improved ventilation status. Functional residual capacity (FRC) decreases on average by 18% in the third trimester and is further compromised in the case of ARDS [9]. Given the increase in FRC that occurs postpartum, this improvement in gas exchange may have improved her hypoxemic state [9].…”

“…Functional residual capacity (FRC) decreases on average by 18% in the third trimester and is further compromised in the case of ARDS [9]. Given the increase in FRC that occurs postpartum, this improvement in gas exchange may have improved her hypoxemic state [9]. Respiratory compliance may also improve post delivery following a downward displacement of the diaphragm [10].…”

Nitric oxide in the treatment of fulminant pulmonary failure in a young pregnant woman with varicella pneumonia

“…Elective delivery is recommended in pregnant women with ARDS beyond 32 weeks' gestation, because significant prolongation of pregnancy is unlikely unless the underlying cause for pulmonary failure is pyelonephritis or varicella pneumonia [ 6]. Fetal deterioration is common during the course of ARDS [ 6], and delivery per se has, as in our patient, a positive impact on maternal status [ 15]. Delivery may also increase the range of therapeutic options available for treatment of the mother including the prone position and pressure limited ventilation with permissive hypercapnia.…”

Fetal outcome in the critically ill pregnant woman

“…Due to the effects of respiratory physiological changes of late pregnancy and the fetal demands for oxygen consumption and carbon dioxide excretion, delivery of the pregnant patient with respiratory failure may result in improvement in the mother’s condition [36]. However, data from small case series addressing this issue have not consistently demonstrated a significant benefit to the mother, and delivery carries a risk of harm [37,38].…”

“…However, data from small case series addressing this issue have not consistently demonstrated a significant benefit to the mother, and delivery carries a risk of harm [37,38]. Although some degree of improvement in oxygenation has been noted [36], this is not associated with improvement in respiratory system compliance or PEEP level [37]. Delivery should therefore not be performed purely in the hope of improving maternal condition, at the expense of the fetus.…”