Treatment of pneumothorax during pregnancy.

Levine, Allan J.; Collins, Frank J.

doi:10.1136/thx.51.3.338

Cited by 18 publications

(10 citation statements)

References 5 publications

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“…Unfortunately, studies looking at the successful use of Heimlich valve for pneumothorax in pregnancy are sparse, most likely due to the rarity of the incidence. In fact, we found only one case in the literature of the use of a one‐way valve for pneumothorax in pregnancy [2].…”

Section: Discussionmentioning

confidence: 89%

Pregnancy with hypoplastic left lung complicated by pneumothorax and pulmonary embolism

Zainudin

Hafidz

Zakaria

et al. 2015

Respirology Case Reports

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We report a case of a 34‐year‐old lady with past history of asthma and pulmonary tuberculosis, who presented 5 weeks pregnant with acute dyspnea. Her chest X‐ray showed left‐sided complete lung collapse and concomitant right‐sided pneumothorax. The pneumothorax was initially managed conservatively with a chest tube but due to its persistence despite suction, was subsequently changed to a PneumostatTM, with which she was later discharged. She had a normal echocardiography (ejection fraction [EF] 67%) at 5 weeks of gestation but developed pulmonary hypertension (EF 55%, pulmonary arterial pressure 40.7 mmHg) as the pregnancy progressed. She delivered a healthy baby at 35 weeks via elective lower section caesarean section with spinal anesthesia. We followed her up postnatally and noted the presence of left‐sided pulmonary embolism, hypoplastic left lung, and left pulmonary artery. The management of this complex case involved a multidisciplinary effort between general medical, respiratory, obstetric, and cardiothoracic teams.

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Section: Discussionmentioning

confidence: 89%

Pregnancy with hypoplastic left lung complicated by pneumothorax and pulmonary embolism

Zainudin

Hafidz

Zakaria

et al. 2015

Respirology Case Reports

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“…There are two reports of women delivering successfully with a chest tube in place then going on to have definitive pneumothorax surgery. One by VATS4 and the other via thoracotomy 5. There was one case of foetal loss which took place at 11 weeks gestation 1.…”

Section: Discussionmentioning

confidence: 99%

A case of recurrent spontaneous pneumothorax during pregnancy treated with video assisted thoracoscopic surgery

et al. 2012

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SummaryPneumothorax during pregnancy is uncommon. Recently ambulatory chest drainage has been advised to treat the pneumothorax and to cover the delivery period. This imposes restrictions on the mother with associated co-morbidity. The authors present a case of recurrent chest-tube resistant pneumothorax during pregnancy which had persisted for 4-weeks .To guide management of a patient referred in the third trimester of pregnancy the authors undertook a systematic review. This led to defi nitive video assisted thoracoscopic surgery (VATS) for bullectomy and pleurodesis which was successful without either peri-operative or peri-partum complications or recurrence of pneumothorax. Our review suggests that a VATS approach during pregnancy is both safe and effective. chest drain insertion there was a continued air leak for 4 days. At this point, and after discussion between chest physicians and obstetricians, a high resolution CT (HR-CT) scan was performed. The HR-CT scan showed left apical bullae, the lung was not fully infl ated with the intercostal drain in situ (fi gure 2). Serial foetal ultrasound scanning over this period found a viable breech presentation singleton foetus with parameters in keeping with gestational age. Liquor volume and foetal movements and heart rate variability were within normal limits. She was then referred for thoracic surgery management. TREATMENTThe 2003 British Thoracic Society guidelines on the management of pneumothorax 2 did not include presentation in pregnancy suggesting the rarity of the condition. The 2010 guidelines for the management of pneumothorax 3 state that there is level C evidence that simple observation and aspiration are usually effective during pregnancy, with elective assisted delivery and regional anaesthesia at or near term. The guidelines also state level D evidence that a VATS procedure should be considered after birth.After discussion between the patient, her family and all professionals it was decided to offer a surgical resolution to this recurrent problem to which she gave informed consent.We chose to undertake VATS pneumothorax surgery because:It is our preferred technique for pneumothorax surgery ▶ as it has smaller incisions than open surgery A dose of 12 mg intramuscular betamethasone was given to aid foetal lung maturity in the event of operative complications necessitating delivery. Foetal ultrasound examination was again normal.At 34 weeks gestation the patient underwent a left sided VATS procedure. Three ports were used (2 × 1 cm and 1 × 1.5 cm). Peri-operative foetal cardiotocography remained normal. The surgical procedure took 15 min (after induction of anaesthesia) and was uncomplicated. The left apical bulla was resected and a mechanical pleural abrasion was performed. Two 24 French intercostal chest drains were inserted and connected to 4kPa suction. Chest x-ray confi rmed satisfactory placement of the chest tubes with full re-infl ation of the lung. Suction to the chest drains was applied continuously for 48 h and the drains were removed at 72...

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“…Non-malignancy-related spontaneous pneumothorax during pregnancy is rare. In the English literature to date only 24 cases have been described [1][2][3] . However the true incidence of this condition is unknown and this number is almost certainly an underestimate.…”

Section: Discussionmentioning

confidence: 99%

Video-Assisted Thoracoscopic Surgical Pleurodesis for Persistent Spontaneous Pneumothorax in Late Pregnancy

Reid

Burgin

2000

Anaesth Intensive Care

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Treatment of pneumothorax during pregnancy.

Cited by 18 publications

References 5 publications

Pregnancy with hypoplastic left lung complicated by pneumothorax and pulmonary embolism

Pregnancy with hypoplastic left lung complicated by pneumothorax and pulmonary embolism

A case of recurrent spontaneous pneumothorax during pregnancy treated with video assisted thoracoscopic surgery

Video-Assisted Thoracoscopic Surgical Pleurodesis for Persistent Spontaneous Pneumothorax in Late Pregnancy

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