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BMJ Case Reports 2009; doi:10.1136/bcr.07.2009.2068
  • Findings that shed new light on the possible pathogenesis of a disease or an adverse effect

Spontaneous pneumothorax in the third trimester of pregnancy

  1. Abriel Avital,
  2. Ori Galante,
  3. Joel Baron,
  4. Alexander Smoliakov,
  5. Dov Heimer,
  6. Lone S Avnun
  1. Soroka University Medical Center, PO Box 151, Beer-Sheva, 84101, Israel
  1. Abriel Avital, avitalab{at}bgu.ac.il
  • Published 18 November 2009

Summary

The present report concerns a young woman previously diagnosed as having childhood asthma who presented with a secondary spontaneous pneumothorax during the third trimester of pregnancy; at term a caesarean section was recommended for safety reasons. Post partum a severe fixed ventilatory defect unresponsive to inhaled bronchodilator and a short oral course of steroids ruled out asthma. Diffuse bronchiectasis was found on her chest CT scan, although this was not evident clinically. Known aetiologies for diffuse bronchiectasis (cystic fibrosis, anti-α1 antitrypsin deficiency, rheumatic diseases, mycobacterial infections, childhood infections and immune deficiencies) were ruled out. Therefore it is believed her bronchiectasis was idiopathic or congenital. No recommendations from recent guidelines on how to manage labour in a woman after a spontaneous pneumothorax could be found. However, a literature search revealed that pregnant women usually experience primary pneumothorax and may continue in natural labour; however, it is unknown how best to manage a woman with secondary spontaneous pneumothorax.

Footnotes

  • Competing interests: None.

  • Patient consent: Patient/guardian consent was obtained for publication.

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