Spontaneous pneumomediastinum in pregnancy: A case report

Scala, Raffaele; Madioni, Chiara; Manta, Carmen; Maggiorelli, Claudia; Maccari, Uberto; Ciarleglio, Giuseppina

doi:10.1016/j.rppnen.2015.09.004

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…El neumomediastino espontáneo posparto es potencialmente benigno y autolimitado cuando no están presentes otros factores, aunque pueden ocurrir complicaciones que pueden ser potencialmente letales (2)(3)(4)(5)(6)(7) . Si la presión mediastínica aumenta abruptamente, la pleura parietal puede romperse, llevando a neumomediastino maligno a tensión, con disnea, cianosis, distensión venosa yugular, hipotensión, shock, edema pulmonar, insuficiencia respiratoria y muerte.…”

Section: Discussionunclassified

“…La electrocardiografía se debe realizar para excluir otras causas de dolor toráci-co, aunque en 25% de los casos puede encontrase inversión de la onda T y cambios inespecíficos del segmento ST (9) . La radiografía con contraste es útil si existe sospecha de síndrome de Borehaave (7) . Aunque este es raro, es importante excluirlo ya que los vómitos son comunes durante el parto.…”

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Neumomediastino y enfisema subcutáneo espontáneos posparto

Tapía¹

2018

Rev peru ginecol obstet.

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La combinación de neumomediastino y enfisema subcutáneo espontáneo posparto es un evento muy raro, que puede ocurrir en la segunda fase del parto y los síntomas usualmente aparecen en el puerperio inmediato, presentándose como dolor torácico agudo, disnea, inflamación de cuello y enfisema subcutáneo. Es una condición benigna y los síntomas generalmente desaparecen en forma espontánea sin consecuencias a largo plazo. No obstante, estos síntomas pueden imitar condiciones fatales. La radiografía de tórax es la prueba diagnóstica más importante, aunque resultados normales no pueden excluir el diagnóstico. Se presenta un caso de primigesta de 20 años con dolor torácico pleurítico asociado a aumento de volumen en área de cara y cuello durante el puerperio inmediato. Tenía enfisema subcutáneo y neumomediastino sin compromiso cardiorrespiratorio significativo. La radiografía y tomografía computada de tórax confirmó ambos hallazgos. La paciente se recuperó con manejo conservador.

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Neumomediastino y enfisema subcutáneo espontáneos posparto

Tapía¹

2018

Rev peru ginecol obstet.

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Postpartum pneumomediastinum and subcutaneous emphysema

2018

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We present the case of a 22-year-old primigravida with symptoms of neck swelling and difficulty breathing 3 hours after uneventful vaginal delivery. On examination, there was surgical emphysema. A CT scan confirmed air in the subcutaneous tissues and also revealed pneumomediastinum. There was no evidence of pneumothorax and gastro-oesophageal endoscopy showed no signs of oesophageal rupture. The patient remained clinically stable throughout her admission and was discharged home after 48 hours of observation. Pneumomediastinum is one of the rare causes of shortness of breath and chest pain during the postpartum period, and it should be considered in the differential diagnosis. Despite the significant abnormalities seen on plain radiography and CT scan, this condition spontaneously resolves. Although postpartum pneumomediastinum has been related to prolonged labour, this was not the case in our patient.

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A Rare Complication during Vaginal Delivery, Hamman’s Syndrome: A Case Report and Systematic Review of Case Reports

Verde

Palmisano

Iavarone

et al. 2022

IJERPH

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Background: Spontaneous pneumomediastinum (SPM) during pregnancy or labor is a rare event. We presented a case report and a systematic review of the literature to provide comprehensive symptoms, treatments, and complications analysis in the pregnant population affected by SPM. Methods: We conducted a comprehensive search of four databases for published papers in all languages from the beginning to 1 September 2021; Results: We included 76 papers with a total of 80 patients. A total of 76% patients were young primiparous, with a median age of 24 ± 5.4 years. The median gestational age was 40 ± 2.4 weeks, with a median duration of labor of 7.4 ± 4.2 h. In 86%, the ethnic origin was not specified. SPM develops in 55% of cases during the second stage of labor. Subcutaneous swelling and subcutaneous emphysema were present in 91.4%. Chest pain and dyspnea were present in 51.4% and 50% of the patients, respectively. We found that 32.9% patients had crepitus, and less common symptoms were dysphonia and tachycardia (14.3% and 14.3%, respectively). Oxygen and bronchodilators were used in 37.7% of the cases. Analgesics or sedatives were administered in 27.1%. Conservative management or the observation was performed in 21.4% and 28.6%, respectively. Antibiotics treatment was offered in 14.3%, whereas invasive procedures such as chest-tube drainage were used in just 5.7% of patients. There were no complications documented in most SPM (70.0%). We found that 16.7% of the SPM developed a pneumothorax and 5% developed a pneumopericardium.; Conclusions: In pregnancy, SPM occurs as subcutaneous swelling or emphysema during the second stage of labor. The treatment is usually conservative, with oxygen and bronchodilators and a low sequela rate. A universal consensus on therapy of spontaneous pneumomediastinum in pregnancy is necessary to reduce the risk of complications.

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Spontaneous pneumomediastinum in pregnancy: A case report

Cited by 4 publications

References 8 publications

Neumomediastino y enfisema subcutáneo espontáneos posparto

Neumomediastino y enfisema subcutáneo espontáneos posparto

Postpartum pneumomediastinum and subcutaneous emphysema

A Rare Complication during Vaginal Delivery, Hamman’s Syndrome: A Case Report and Systematic Review of Case Reports

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