Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-4hhp2 Total loading time: 0 Render date: 2024-06-11T04:44:59.086Z Has data issue: false hasContentIssue false

25 - Mechanical Ventilation in Pregnancy

from Section 5 - Other Pulmonary Issues in Pregnancy

Published online by Cambridge University Press:  14 April 2020

By
Jose Antonio Rojas-Suarez  and
Jezid Miranda
Edited by
Stephen E. Lapinsky  and
Lauren A. Plante
Stephen E. Lapinsky
Affiliation:
Mount Sinai Hospital, Toronto
Lauren A. Plante
Affiliation:
Drexel University Hospital, Philadelphia
Get access

Summary

Respiratory failure is an uncommon complication of pregnancy, affecting only 0.1% of pregnant women; however, it is one of the main indications for intensive care unit (ICU) admission of pregnant and peri-partum women. Pregnancy is a unique physiologic state in women’s lives, and physicians should be familiar with it. Given the low incidence of respiratory failure during pregnancy, there is limited scientific evidence about the best strategies for this population.

Type
Chapter
Information
Respiratory Disease in Pregnancy , pp. 233 - 244
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Schwaiberger, D, Karcz, M, Menk, M, Papadakos, PJ, Dantoni, SE. Respiratory failure and mechanical ventilation in the pregnant patient. Crit Care Clin. 2016 32:85–95.CrossRefGoogle ScholarPubMed
Rush, B, Martinka, P, Kilb, B, et al. Acute respiratory distress syndrome in pregnant women. Obstet Gynecol. 2017 129:530–5.Google Scholar
Lapinsky, SE, Rojas-Suarez, JA, Crozier, TM, et al. Mechanical ventilation in critically-ill pregnant women: a case series. Int J Obstet Anesth. 2015 24:323–8.Google Scholar
Raghuraman, N, Temming, LA, Stout, MJ, et al. Intrauterine hyperoxemia and risk of neonatal morbidity. Obstet Gynecol. 2017 129:676–82.Google Scholar
Meschia, G. Fetal oxygenation and maternal ventilation. Clin Chest Med. 2011 32:15–19.CrossRefGoogle ScholarPubMed
Tomimatsu, T, Kakigano, A, Mimura, K, et al. Maternal carbon dioxide level during labor and its possible effect on fetal cerebral oxygenation: mini review. J Obstet Gynaecol Res. 2013 39:1–6.Google Scholar
Elsayegh, D, Shapiro, JM. Management of the obstetric patient with status asthmaticus. J Intensive Care Med 2008 23:396–402.Google Scholar
Tomimatsu, T, Kakigano, A, Mimura, K, et al. Maternal hyperventilation during labor revisited: its effects on fetal oxygenation. Reprod Sci. 2012 19:1169–74.CrossRefGoogle ScholarPubMed
Lapinsky, SE. Acute respiratory failure in pregnancy. Obstet Med. 2015 8:126–32.Google Scholar
Martillotti, G, Boehlen, F, Robert-Ebadi, H, et al. Treatment options for severe pulmonary embolism during pregnancy and the postpartum period: a systematic review. J Thromb Haemost. 2017 15:1942–50.Google Scholar
The ARDS Definition Task Force; Ranieri, VM, Rubenfeld, GD, Thompson, BT, et al. Acute respiratory distress syndrome: the Berlin definition. J Am Med Assoc. 2012 307(1).Google Scholar
Rush, B, Martinka, P, Kilb, B, et al. Acute respiratory distress syndrome in pregnant women. Obstet Gynecol. 2017 129:530–5.Google Scholar
Hegewald, MJ, Crapo, RO. Respiratory physiology in pregnancy. Clin Chest Med 2011 32:1–13.CrossRefGoogle ScholarPubMed
Silversides, JA, Major, E, Ferguson, AJ, et al. Conservative fluid management or deresuscitation for patients with sepsis or acute respiratory distress syndrome following the resuscitation phase of critical illness: a systematic review and meta-analysis. Intensive Care Med. 2017 43:155–70.Google Scholar
Kwon, HL, Triche, EW, Belanger, K, Bracken, MB. The epidemiology of asthma during pregnancy: prevalence, diagnosis, and symptoms. Immunol Allergy Clin North Am 2006 26:29–62.Google Scholar
Bonham, CA, Patterson, KC, Strek, ME. Asthma outcomes and management during pregnancy. Chest 2018 153(2):515–27.Google Scholar
Rochwerg, B, Brochard, L, Elliott, MW, et al. Official ERS/ATS clinical practice guidelines: noninvasive ventilation for acute respiratory failure. Eur Respir J. 2017 50:1602426.Google Scholar
Vital, FM, Ladeira, MT, Atallah, ÁN. Non-invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema. Cochrane Database Syst Rev. 2013 (5):CD005351.Google Scholar
Xu, X-P, Zhang, XC, Hu, SL, et al. Noninvasive ventilation in acute hypoxemic nonhypercapnic respiratory failure: a systematic review and meta-analysis. Crit Care Med. 2017 45:e727–33.CrossRefGoogle ScholarPubMed
Dennis, AT, Solnordal, CB. Acute pulmonary oedema in pregnant women. Anaesthesia 2012 67:646–59.Google Scholar
Rojas-Suarez, J, Cogollo-González, M, García-Rodríguez, MC, Paternina-Caicedo, A, Miranda-Quintero, J. Non-invasive mechanical ventilation as adjuvant strategy in the management of acute respiratory failure secondary to peripartum pulmonary edema in severe preeclampsia. [Article in Spanish] Med Intensiva. 2011 35(8):518–19.Google Scholar
United States Food and Drug Administration. FDA drug safety communication: FDA review results in new warnings about using general anesthetics and sedation drugs in young children and pregnant women. 2016. www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-review-results-new-warnings-about-using-general-anesthetics-and (accessed November 2019).Google Scholar
Chidambaran, V, Costandi, A, D’Mello, A. Propofol: a review of its role in pediatric anesthesia and sedation. CNS Drugs. 2015 29:543–63.Google Scholar
Olutoye, OA, Baker, BW, Belfort, MA, Olutoye, OO. Food and Drug Administration warning on anesthesia and brain development: implications for obstetric and fetal surgery. Am J Obstet Gynecol. 2017 218(1):98–102.Google Scholar
Guay, J, Grenier, Y, Varin, F. Clinical pharmacokinetics of neuromuscular relaxants in pregnancy. Clin Pharmacokinet. 1998 34:483–96.Google Scholar
Fujinaga, M, Baden, JM, Mazze, RI. Developmental toxicity of nondepolarizing muscle relaxants in cultured rat embryos. Anesthesiology. 1992 76:999–1003.Google Scholar
Karabulut, AK, Reisli, R, Uysal, II, Celik, JB, Ziylan, T. An investigation of non-depolarizing muscle relaxants on embryonic development in cultured rat embryos. Eur J Anaesthesiol. 2004 21:715–24.CrossRefGoogle ScholarPubMed
Perreault, C, Guay, J, Gaudreault, P, Cyrenne, L, Varin, F. Residual curarization in the neonate after caesarean section. Can J Anaesth. 1991 38:587–91.Google Scholar
Guay, J. Are non-depolarizing neuromuscular blocking agents innocuous for the neonates? Can J Anaesth. 2005 52:213; author reply 213–14.CrossRefGoogle ScholarPubMed
Spelten, O, Fiedler, F, Schier, R, Wetsch, WA, Hinkelbein, J. Transcutaneous PtcCO2 measurement in combination with arterial blood gas analysis provides superior accuracy and reliability in ICU patients. J Clin Monit Comput. 2017 31(1):153–8.Google Scholar
Rossi, A, Cornette, J, Johnson, MR, et al. Quantitative cardiovascular magnetic resonance in pregnant women: cross-sectional analysis of physiological parameters throughout pregnancy and the impact of the supine position. J Cardiovasc Magn Reson 2011 13:31.Google Scholar
Cherpanath, TGV, Hirsch, A, Geerts, BF, et al. Predicting fluid responsiveness by passive leg raising: a systematic review and meta-analysis of 23 clinical trials. Crit Care Med. 2016 44:981–91.CrossRefGoogle ScholarPubMed
Vartun, A, Flo, K, Acharya, G. Effect of passive leg raising on systemic hemodynamics of pregnant women: a dynamic assessment of maternal cardiovascular function at 22–24 weeks of gestation. PLoS One 2014 9(4):e94629.CrossRefGoogle ScholarPubMed
Volpicelli, G, Elbarbary, M, Blaivas, M, et al. International evidence-based recommendations for point-of-care lung ultrasound. Intensive Care Med 2012 38:577–91.Google Scholar
Zieleskiewicz, L, Contargyris, C, Brun, C, et al. Lung ultrasound predicts interstitial syndrome and hemodynamic profile in parturients with severe preeclampsia. Anesthesiology. 2014 120:906–14.CrossRefGoogle ScholarPubMed
Paternot, A, Repessé, X, Vieillard-Baron, A. Rationale and description of right ventricle-protective ventilation in ARDS. Respir Care. 2016 61:1391–6.Google Scholar
Vieillard-Baron, A, Matthay, M, Teboul, JL, et al. Experts’ opinion on management of hemodynamics in ARDS patients: focus on the effects of mechanical ventilation. Intensive Care Med. 2016 42:739–49.Google Scholar
Jain, D, Grejs, AM, Bhavsar, R, et al. Focused cardiac ultrasound is feasible in parturients; a prospective observational study. Acta Anaesthesiol Scand. 2017 61:1105–13.Google Scholar
Levinson, G, Shnider, SM, DeLorimier, AA, Steffenson, JL Effects of maternal hyperventilation on uterine blood flow and fetal oxygenation and acid-base status. Anesthesiology. 1974 40:340–7.Google Scholar
Ginosar, Y, Gielchinsky, Y, Nachmansson, N, et al. BOLD-MRI demonstrates acute placental and fetal organ hypoperfusion with fetal brain sparing during hypercapnia. Placenta. 2018 63:53–60.Google Scholar
Fraser, D, Jensen, D, Wolfe, LA, et al. Fetal heart rate response to maternal hypocapnia and hypercapnia in late gestation. J Obstet Gynaecol Can. 2008 30:312–16.CrossRefGoogle ScholarPubMed
Ritchie, JWK, Lakhani, K. Fetal breathing movements in response to maternal inhalation of 5% carbon dioxide. Am J Obstet Gynecol. 1980 136:386–8.Google Scholar
Baschat, AA, Gembruch, U. The cerebroplacental Doppler ratio revisited. Ultrasound Obstet Gynecol. 2003 21:124–7.Google Scholar
Nicolaides, KH, Bakalis, S, Akolekar, R, Gallo, DM, Poon, LC. Umbilical and fetal middle cerebral artery Doppler at 30–34 weeks’ gestation in the prediction of adverse perinatal outcome. Ultrasound Obstet Gynecol. 2015 45:409–20.Google Scholar
Figueras, F, Gardosi, J. Intrauterine growth restriction: new concepts in antenatal surveillance, diagnosis, and management. Am J Obstet Gynecol. 2011 204:288–300.Google Scholar
Figueras, F, Gratacós, E. Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther. 2014 36:86–98.Google Scholar
Clark, SL, Nageotte, MP, Garite, TJ, et al. Intrapartum management of category II fetal heart rate tracings: towards standardization of care. Am J Obstet Gynecol. 2013 209:89–97.Google Scholar
ACOG. Management of intrapartum fetal heart rate tracings. Obstet Gynecol. 2010 116:1232–40.Google Scholar
Nageotte, MP. Fetal heart rate monitoring. Semin Fetal Neonatal Med. 2015 20:144–8.Google Scholar
Raghuraman, N, Cahill, AG. Update on fetal monitoring: overview of approaches and management of category ii tracings. Obstet Gynecol Clin North Am. 2017 44:615–24.CrossRefGoogle ScholarPubMed
Guérin, C, Busana, M, Giosa, L, Macrì, MM, Quintel, M. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med. 2013 368:2159–68.Google Scholar
Oliveira, C, Lopes, MAB, Rodrigues, AS, Zugaib, M, Francisco, RPV. Influence of the prone position on a stretcher for pregnant women on maternal and fetal hemodynamic parameters and comfort in pregnancy. Clinics 2017 72(6):325–32.Google Scholar
Pillai, A, Chikhani, M, Hardman, JG. Apnoeic oxygenation in pregnancy: a modelling investigation. Anaesthesia. 2016 71:1077–80.Google ScholarPubMed
McClelland, SH, Bogod, DG, Hardman, JG. Pre-oxygenation and apnoea in pregnancy: changes during labour and with obstetric morbidity in a computational simulation. Anaesthesia. 2009 64:371–7.Google Scholar
Sharma, NS, Wille, KM, Bellot, SC, Diaz-Guzman, E. Modern use of extracorporeal life support in pregnancy and postpartum. ASAIO J. 2015 61:110–14.Google Scholar
Saad, AF, Rahman, M, Maybauer, DM, et al. Extracorporeal membrane oxygenation in pregnant and postpartum women with H1N1-related acute respiratory distress syndrome. Obstet Gynecol. 2016 127:241–7.CrossRefGoogle ScholarPubMed
Daily, WH, Katz, AR, Tonnesen, A, Allen, SJ. Beneficial effect of delivery in a patient with adult respiratory distress syndrome. Anesthesiology. 1990 72:383–6.Google Scholar
Catanzarite, V, Willms, D, Wong, D, et al. Acute respiratory distress syndrome in pregnancy and the puerperium: causes, courses, and outcomes. Obstet Gynecol. 2001 97:760–4.Google Scholar
Tomlinson, MW, Caruthers, TJ, Whitty, JE, Gonik, B. Does delivery improve maternal condition in the respiratory-compromised gravida? Obstet Gynecol. 1998 91:108–11.Google Scholar
Mabie, WC, Barton, JR, Sibai, BM. Adult respiratory distress syndrome in pregnancy. Am J Obstet Gynecol. 1992 167:950–7.Google Scholar
Jenkins, TM, Troiano, NH, Graves, CR, Baird, SM, Boehm, FH. Mechanical ventilation in an obstetric population: characteristics and delivery rates. Am J Obstet Gynecol. 2003 188:549–52.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×