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Restrictive Lung Disease in PregnancyRestrictive Lung Disease in Pregnancy

Stephen E. Lapinsky, MBBCh; Carolyn Tram, MD; Sangeeta Mehta, MD; Cynthia V. Maxwell, MD
Author and Funding Information

From the ICU (Drs Lapinsky and Mehta) and the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynaecology (Dr Maxwell), Mount Sinai Hospital; and the Interdepartmental Division of Critical Care Medicine (Drs Lapinsky, Tram, and Mehta), University of Toronto, Toronto, ON.

Correspondence to: Stephen E. Lapinsky, MBBCh, 600 University Ave, Room 18-214, Toronto, ON M5G 1X5, Canada; e-mail: stephen.lapinsky@utoronto.ca


Some of these data have been presented previously at the 6th Meeting of the International Society for Obstetric Medicine, July 7-8, 2012, London, England, and at CHEST 2012, October 20-25, 2012, Atlanta, GA, and have been presented in abstract form (Tram C, Lapinsky S, Maxwell C. Restrictive lung disease in pregnancy. Chest. 2012;142[4_MeetingAbstracts]:382A).

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2014;145(2):394-398. doi:10.1378/chest.13-0587
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Restrictive lung disease is uncommon in pregnancy. We reviewed 15 pregnancies in 12 women with restrictive disease due to kyphoscoliosis, neuromuscular disease, or parenchymal lung disease. Median FVC was 40% predicted, and six women (50%) had an FVC < 1.0 L. In the 14 pregnancies in which at least two spirometry readings were available, FVC increased in three pregnancies, decreased in three, and remained stable in eight, with maximal changes of 0.4 L. Three women required supplemental oxygen, and one woman with neuromuscular disease required noninvasive ventilation. Premature delivery occurred in nine pregnancies (60%), and 10 deliveries (67%) were by cesarean section. Neuraxial anesthesia was used in 10 of 15 deliveries but was limited in the others by difficult spinal anatomy. There was no maternal or neonatal mortality. Women with restrictive lung disease tolerate pregnancy reasonably well, but many have premature delivery. A multidisciplinary approach is essential, with monitoring of spirometry and oxygenation and planning for labor and delivery.

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