Breathing for Two: Unraveling the Complex Interplay of Pregnancy and Respiratory Physiology
Saumy Johnson, Jerry Paul
Keywords :
Pregnancy, Respiratory, Respiratory system
Citation Information :
Johnson S, Paul J. Breathing for Two: Unraveling the Complex Interplay of Pregnancy and Respiratory Physiology. Indian J Respir Care 2024; 13 (1):54-59.
This review explores the distinctive physiological adjustments taking place in the respiratory system throughout a typical pregnancy. These adaptations encompass modifications in lung function, volume, respiratory resistance, and conductance. Though vital to support both the mother and the fetus, they can also heighten vulnerability to illnesses and exacerbate preexisting conditions. Additionally, the review underlines the complexities related to interpreting laboratory and imaging studies due to these physiological shifts, along with potential risks during nasal and endotracheal intubation. Nevertheless, critical pulmonary parameters, such as static and dynamic compliance, diffusing capacity, and static lung recoil pressure typically remain steady. The review concludes by delving into pathologic disorders and conditions that may manifest during pregnancy, underscoring the significance of monitoring respiratory function and promptly addressing any complications. In summary, this review offers valuable insights into the distinct respiratory transformations observed during pregnancy and their potential consequences for the well-being of both the mother and the fetus.
Lapinsky SE, Nelson-Piercy C. The lungs in obstetric and gynecologic diseases. Murray and Nadel's Textbook Resp Med 2016:1679–1690. DOI: 10.1016/B978-1-4557-3383-5.00096-8
Ellegard EK. Clinical and pathologic characteristics of pregnancy rhinitis. Clin Rev Allergy Immunol 2004;26(3):149–159. DOI: 10.1385/CRIAI:26:3:149
Weinberger SE, Weiss ST, Cohen WR, et al. Pregnancy and the lung. Am Rev Respir Dis 1980;121(3):559–581. DOI: 10.1164/arrd.1980.121.3.559
Contreras G, Gutiérrez M, Beroíza T, et al. Ventilatory drive and respiratory muscle function in pregnancy. Am Rev Respir Dis 1991;144(4):837–841. DOI: 10.1164/ajrccm/144.4.837
Gilroy RJ, Mangura BT, Lavietes MH. Rib cage and abdominal volume displacements during breathing in pregnancy. Am Rev Respir Dis 1988;137(3):668–672. DOI: 10.1164/ajrccm/137.3.668
Jensen D, Webb KA, Davies GA, et al. Mechanical ventilatory constraints during incremental cycle exercise in human pregnancy: implications for respiratory sensation. J Physiol 2008;586(19):4735–4750. DOI: 10.1113/jphysiol.2008.158154
Kolarzyk E, Szot WM, Lyszczarz J. Lung function and breathing regulation parameters during pregnancy. Arch Gynecol Obstet 2005;272(1):53–58. DOI: 10.1007/s00404-004-0691-1
Lapinsky SE, Tram C, Mehta S, et al. Restrictive lung disease in pregnancy. Chest 2014;145(2):394–398. DOI: 10.1378/chest.13-0587
Lemos A, de Souza AI, Figueiroa JN, et al. Respiratory muscle strength in pregnancy. Respir Med 2010;104(11):1638–1644. DOI: 10.1016/j.rmed.2010.05.020
Kwon HL, Triche EW, Belanger K, et al. The epidemiology of asthma during pregnancy: prevalence, diagnosis, and symptoms. Immunol Allergy Clin North Am 2006;26(1):29–62. DOI: 10.1016/j.iac.2005.11.002
Shebl E, Chakraborty RK. Asthma In Pregnancy. Treasure Island (FL): StatPearls Publishing; 2022.
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(5 Pt 1):760–764. DOI: 10.1016/s0029-7844(00)01231-x
Kotloff RM, FitzSimmons SC, Fiel SB. Fertility and pregnancy in patients with cystic fibrosis. Clin Chest Med 1992;13(4):623–635.
Edenborough FP, Stableforth DE, Webb AK, et al. The outcome of pregnancy in cystic fibrosis. Thorax 1995;50(2):170–174. DOI: 10.1136/thx.50.2.170
Boyd JM, Metha A, Murphy DJ. Fertility and pregnancy outcomes in men and women with cystic fibrosis in the United Kingdom.Hum Reprod 2004;19(10):2238–2243. DOI: 10.1093/humrep/deh405
Lau EM, Barnes DJ, Moriarty C, et al. Pregnancy outcomes in the current era of cystic fibrosis care: a 15-year experience. Aust N Z J Obstet Gynaecol 2011;51(3):220–224. DOI: 10.1111/j.1479-828X.2010.01287.x
Lam CM, Wong SF, Leung TN, et al. A case-controlled study comparing clinical course and outcomes of pregnant and nonpregnant women with severe acute respiratory syndrome. BJOG 2004;111(8):771–774. DOI: 10.1111/j.1471-0528.2004.00199.x
Wong SF, Chow KM, de Swiet M. Severe acute respiratory syndrome and pregnancy. BJOG 2003;110(7):641–642. DOI: 10.1046/j.1471-0528.2003.03008.x
Kaur H, Kolli M. Acute pulmonary edema in pregnancy - fluid overload or atypical pre-eclampsia. Cureus 2021;13(11):e19305. DOI: 10.7759/cureus.19305
Saxena A, Relan J. Pregnancy with congenital heart disease. Vessel Plus 2022;6:15. DOI: 10.20517/2574-1209.2021.96
Pordeus ACB, Katz L, Soares MC, et al. Acute pulmonary edema in an obstetric intensive care unit: a case series study. Medicine (Baltimore) 2018;97(28):e11508. DOI: 10.1097/MD.0000000000011508
Sliwa K, van Hagen IM, Budts W, et al. Pulmonary hypertension and pregnancy outcomes: data from the registry of pregnancy and cardiac disease (ROPAC) of the European Society of Cardiology. Eur J Heart Fail 2016;18(9):1119–1128. DOI: 10.1002/ejhf.594
Leonhardt G, Gaul C, Nietsch HH, et al. Thrombolytic therapy in pregnancy. J Thromb Thrombolysis 2006;21(3):271–276. DOI: 10.1007/s11239-006-5709-z
Abe K, Kuklina EV, Hooper WC, et al. Venous thromboembolism as a cause of severe maternal morbidity and mortality in the United States. Semin Perinatol 2019;43(4):200–204. DOI: 10.1053/j.semperi.2019.03.004
Kaur K, Bhardwaj M, Kumar P, et al. Amniotic fluid embolism. J Anaesthesiol Clin Pharmacol 2016;32(2):153–159. DOI: 10.4103/0970-9185.173356
Chung F, Memtsoudis SG, Ramachandran SK, et al. Society of anesthesia and sleep medicine guidelines on preoperative screening and assessment of adult patients with obstructive sleep apnea. Anesth Analg 2016;123(2):452–473. DOI: 10.1213/ANE.0000000000001416
Grant-Orser A, Metcalfe A, Pope JE, et al. Pregnancy considerations for patients with interstitial lung disease. Chest 2022;162(5):1093–1105. DOI: 10.1016/j.chest.2022.06.024
Zanetti G, Hochhegger B, Marchiori E. Pulmonary endometriosis: an unusual cause of hemoptysis. J Bras Pneumol 2020;46(4):e20190335. DOI: 10.36416/1806-3756/e20190335
Visouli AN, Zarogoulidis K, Kougioumtzi I, et al. Catamenial pneumothorax. J Thorac Dis 2014;6(Suppl 4):S448–S460. DOI: 10.3978/j.issn.2072-1439.2014.08.49
Vasdev GM, Harrison BA, Keegan MT, et al. Management of the difficult and failed airway in obstetric anesthesia. J Anesth 2008;22(1):38–48. DOI: 10.1007/s00540-007-0577-z
Mushambi MC, Kinsella SM, Popat M, et al. Obstetric Anaesthetists’ Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia 2015;70(11):1286–1306. DOI: 10.1111/anae.13260
Hannig KE, Hauritz RW, Jessen C, et al. Managing known difficult airways in obstetric patients using a flexible bronchoscope and IRRIS: a case-illustrated guide for nonexpert anesthesiologists, without surgical backup. Case Rep Anesthesiol 2021;2021:6778805. DOI: 10.1155/2021/6778805
