Hypoxaemia during pregnancy: pulmonary arteriovenous dilatation as a likely cause

Veil-Picard, M.; Cattin, Julie; Chopard, Romain; Schiele, François; Riethmuller, Didier; Dalphin, Jean‐Charles; Degano, Bruno

doi:10.1183/09059180.00003514

Cited by 4 publications

(3 citation statements)

References 13 publications

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“…In contrast, hypoxemia may help in early identification of PAVF. The recurrent transient drop in oxygen saturation may be one of the clinical manifestations in pregnant women with PAVF and should therefore be closely monitored [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Attention to pulmonary arteriovenous fistula in a case of transient hypoxemia and cerebral infarction during pregnancy: a case report and literature review

Shu,

Luo,

Zuo

2023

BMC Pregnancy Childbirth

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Background Pulmonary arteriovenous fistula is rare during pregnancy. Pulmonary arteriovenous fistula presents no pulmonary symptoms in most patients but can be exacerbated by pregnancy. If not diagnosed and treated promptly, pulmonary arteriovenous fistula can lead to respiratory failure, stroke, spontaneous hemothorax, or other fatal complications. Case presentation A 29-year-old healthy pregnant woman presented with a transient drop in blood oxygen level of unknown cause during a routine examination at 34 weeks of gestation and during a cesarean section at 38 weeks of pregnancy. The patient’s oxygen saturation quickly returned to normal and was not further investigated. On day 3 postpartum, the patient suddenly displayed slurred speech and right limb myasthenia. A head magnetic resonance imaging revealed cerebral infarction in the left basal ganglia. Subsequent computed tomography pulmonary arteriography revealed bilateral pulmonary arteriovenous fistula, which was likely the cause of cerebral infarction. The patient was transferred to the Department of Thoracic Surgery after one month of treatment and successfully underwent percutaneous embolization of pulmonary arteriovenous fistula. Conclusion Pulmonary arteriovenous fistula should not be neglected if a pregnant woman presents with transient hypoxemia and cerebral infarction. A transient decrease in pulse oxygen saturation that cannot be explained by common clinical causes can be an early warning sign of the disease. Early diagnosis and multidisciplinary management could improve the prognosis.

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Section: Discussionmentioning

confidence: 99%

Attention to pulmonary arteriovenous fistula in a case of transient hypoxemia and cerebral infarction during pregnancy: a case report and literature review

Shu,

Luo,

Zuo

2023

BMC Pregnancy Childbirth

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“…This similar mechanism may also be partially responsible for pulmonary artery dilatations during gestation. In a case report by Veil-Picard et al [23], symptomatic hypoxaemia during pregnancy was described as a result of transient pulmonary arteriovenous dilatation. In this patient, oestrogen-mediated augmentation and proliferation of blood vessels was the probable mechanism, and all symptoms resolved postpartum along with spontaneous regression of vascular changes.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary artery dilatation during normal pregnancy

Golińska‐Grzybała

Wiechec²,

Goliński³

et al. 2018

Kardiol Pol

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“…And symptomatic hypoxaemia during pregnancy may be a result of transient pulmonary arteriovenous dilatation [4]. Besides, progesterone can also change the tension of smooth muscle, increase vasodilation and volume [5].…”

Section: Introductionmentioning

confidence: 99%

Association of maternal main pulmonary arterial diameter and neonatal birth weight: a study based on pulmonary arterial hypertension

Zhao

Zhang

Yang

et al. 2022

Preprint

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OBJECTIVE To study the association of maternal main pulmonary arterial diameter and neonatal weight of pregnant women with pulmonary arterial hypertension. METHODS We divide patients into 2 group, according to whether the patients with pulmonary arterial hypertension owing to congenital heart disease, or idiopathic pulmonary arterial hypertension. Univariate and multivariate regression analysis were used. After adjusting for various confounding, tangent points were obtained by fitting curves and threshold effect analysis. Finally, we apply a stratified analysis according to New York Heart Association (NYHA) Functional Classification. RESULTS According to the results of multivariate regression analysis, in patients with PAH owing to congenital heart disease, maternal pulmonary arterial diameter was significantly associated with neonatal birth weight, and the regression coefficient was − 37.03, and the 95% confidence interval was − 63.44 to -10.62, P value < 0.001. The result of regression analysis is that when maternal main pulmonary arterial diameter increases by 1 mm, the weight of the newborn will decrease by 37.03g. After stratified analysis, the regression coefficient was − 40.94, and the 95% confidence interval was − 69.68 to -12.20, P value < 0.001. CONCLUSION The maternal main pulmonary artery diameter was significantly correlated with the neonatal birth weight in patients with pulmonary arterial hypertension owing to congenital heart diseases, especially thoses with functional classification I or II.

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Hypoxaemia during pregnancy: pulmonary arteriovenous dilatation as a likely cause

Cited by 4 publications

References 13 publications

Attention to pulmonary arteriovenous fistula in a case of transient hypoxemia and cerebral infarction during pregnancy: a case report and literature review

Attention to pulmonary arteriovenous fistula in a case of transient hypoxemia and cerebral infarction during pregnancy: a case report and literature review

Pulmonary artery dilatation during normal pregnancy

Association of maternal main pulmonary arterial diameter and neonatal birth weight: a study based on pulmonary arterial hypertension

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