Indian Journal of Respiratory Care

IJRC Email      Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Volume  13 (2024)
Volume  12 (2023)
Volume  11 (2022)
Volume  10 (2021)
Volume  9 (2020)
Volume  8 (2019)
Volume  7 (2018)
Volume  6 (2017)
Volume  5 (2016)
Volume  4 (2015)
Volume  3 (2014)
Volume  2 (2013)
Volume  1 (2012)
Related articles

VOLUME 9 , ISSUE 1 ( January-June, 2020 ) > List of Articles

REVIEW ARTICLE

Acute Respiratory Distress Syndrome in Pregnancy and Peripartum: Facts and Figures

Nissar Shaikh, Abdul Gafoor M Tharayil, Arshad H. Chanda, Adel E. Ahmed Ganaw, Muhammad Shakeeel Riaz, Stefan Alfred Hubertus Rohrig, Marcus Lance

Keywords : Acute respiratory distress syndrome, arterial blood gas, chest X-ray, excluding cardiogenic pulmonary edema, extracorporeal membrane oxygenation, neuromuscular blocking agents, peripartum, pregnancy, steroids

Citation Information : Shaikh N, Tharayil AG, Chanda AH, Ganaw AE, Riaz MS, Rohrig SA, Lance M. Acute Respiratory Distress Syndrome in Pregnancy and Peripartum: Facts and Figures. Indian J Respir Care 2020; 9 (1):12-19.

DOI: 10.4103/ijrc.ijrc_34_19

License: CC BY-NC-SA 4.0

Published Online: 08-12-2022

Copyright Statement:  Copyright © 2020; Indian Journal of Respiratory Care.


Abstract

Acute respiratory distress syndrome (ARDS) is a serious condition occurring rarely during pregnancy and peripartum period. ARDS occurs either due to pregnancy associated risk factors or due to the increased risk during pregnancy. Clinical presentation, arterial blood gas, chest X-ray, and computerized tomography will help in the diagnosis of ARDS. Management of ARDS in pregnancy and peripartum period can be summarized by the “ARDS12,” including lung protective ventilation (lower tidal volume, higher respiratory rate, positive end expiratory pressure titration), negative fluid balance, neuromuscular blocking agents, prone position, use of inhaled nitric oxide, high frequency oscillation ventilation, extracorporeal membrane oxygenation, extracorporeal carbon dioxide removal, use of corticosteroids and continuing the supportive care. Overall morality from ARDS is showing decreasing trends, and the mortality during pregnancy and peripartum period is significantly lower than in general population.

HTML PDF Share
  1. Pollock W, Rose L, Dennis CL. Pregnant and postpartum admissions to the intensive care unit: A systematic review. Intensive Care Med 2010;36:1465-74.
  2. Lapinsky SE. Acute respiratory failure in pregnancy. Obstet Med 2015;8:126-32.
  3. Soma-Pillay P, Nelson-Piercy C, Tolppanen H, Mebazaa A. Physiological changes in pregnancy. Cardiovasc J Afr 2016;27:89-94.
  4. Carter AM. Placental Gas Exchange and the Oxygen Supply to the Fetus. Compr Physiol 2015;5:1381-403.
  5. Bandi VD, Munnur U, Matthay MA. Acute lung injury and acute respiratory distress syndrome in pregnancy. Crit Care Clin 2004;20:577-607.
  6. Perry KG Jr., Martin RW, Blake PG, Roberts WE, Martin JN Jr. Maternal mortality associated with adult respiratory distress syndrome. South Med J 1998;91:441-4.
  7. Carmona F, Fábregues F, Alvarez R, Vila J, Cararach V. A rare case of chorioamnionitis by Morganella morganii complicated by septicemia and adult respiratory distress syndrome. Eur J Obstet Gynecol Reprod Biol 1992;45:67-70.
  8. Singh Y, Shankar A, Rohatgi S. Abruptio placentae leading to fetal death and adult respiratory distress syndrome. Med J Armed Forces India 2008;64:389-90.
  9. Abenhaim HA, Azoulay L, Kramer MS, Leduc L. Incidence and risk factors of amniotic fluid embolisms: A population-based study on 3 million births in the United States. Am J Obstet Gynecol 2008;199:49. e1-8.
  10. Bharati S, Chakrabarty A, Bhattacharyya P. Transfusion-related acute lung injury in a case of acute ruptured ectopic pregnancy. Saudi J Health Sci 2014;3:43-6.
  11. Bennett A, Chunilal S. Diagnosis and management of deep vein thrombosis and pulmonary embolism in pregnancy. Semin Thromb Hemost 2016;42:760-73.
  12. Bates SM, Greer IA, Middeldorp S, Veenstra DL, Prabulos AM, Vandvik PO. VTE, thrombophilia, antithrombotic therapy, and pregnancy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012;141:e691S-736S.
  13. Kwon HL, Belanger K, Bracken MB. Effect of pregnancy and stage of pregnancy on asthma severity: A systematic review. Am J Obstet Gynecol 2004;190:1201-10.
  14. Murphy VE, Gibson P, Talbot PI, Clifton VL. Severe asthma exacerbations during pregnancy. Obstet Gynecol 2005;106:1046-54.
  15. Wack EE, Ampel NM, Galgiani JN, Bronnimann DA. Coccidioidomycosis during pregnancy. An analysis of ten cases among 47,120 pregnancies. Chest 1988;94:376-9.
  16. Hunga CY, Hua HC, Chiua LC, Changa CH, Lia LF, Huanga CC, et al. Maternal and neonatal outcomes ofrespiratory failure during pregnancy. J Formoson Med Assoc 2018; 117:404-12.
  17. Kankuri E, Kurki T, Carlson P, Hiilesmaa V. Incidence, treatment and outcome of peripartum sepsis. Acta Obstet Gynecol Scand 2003;82:730-5.
  18. Vishnu Priya KM, Sheela CN, Banka S, Mahalakshmi T. Maternal and perinatal outcome of acute pancreatitis during pregnancy: A 5 year experience at a tertiary care centre. Int J Reprod Contracept Obstet Gynecol 2016;5:4041-5.
  19. Murphy NJ, Quinlan JD. Trauma in pregnancy: Assessment, management, and prevention. Am Fam Physician 2014;90:717-22.
  20. Chambers J, Smith N, Sehring M, Chittivelu S. Acute chest syndrome progressing to ARDS in a patient of 25-week gestation. Case Rep Crit Care 2018;2018:3.
  21. Pfeilsticker FJ, Serpa Neto A. ‘Lung-protective’ ventilation in acute respiratory distress syndrome: Still a challenge? J Thorac Dis 2017;9:2238-41.
  22. Vianna FS, Pfeilsticker FJ, Serpa Neto A. Driving pressure in obese patients with acute respiratory distress syndrome: One size fits all? J Thorac Dis 2018;10:S3957-S3960.
  23. Writing Group for the Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART) Investigators, Cavalcanti AB, Suzumura ÉA, Laranjeira LN, Paisani DM, Damiani LP, et al. Effect of Lung Recruitment and Titrated Positive End-Expiratory Pressure (PEEP) vs. low PEEP on Mortality in Patients With Acute Respiratory Distress Syndrome: A Randomized Clinical Trial. JAMA 2017;318:1335-45.
  24. Catanzarite V, Willms D, Wong D, Landers C, Cousins L, Schrimmer D. Acute respiratory distress syndrome in pregnancy and the puerperium: Causes, courses, and outcomes. Obstet Gynecol 2001;97:760-4.
  25. Lapinsky SE, Kruczynski K, Slutsky AS. Critical care in the pregnant patient. Am J Respir Crit Care Med 1995;152:427-55.
  26. National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network, Wiedemann HP, Wheeler AP, Bernard GR, Thompson BT, Hayden D, et al. Comparison of two fluid-management strategies in acute lung injury. N Engl J Med 2006;354:2564-75.
  27. Bourenne J, Hraiech S, Roch A, Gainnier M, Papazian L, Forel JM. Sedation and neuromuscular blocking agents in acute respiratory distress syndrome. Ann Transl Med 2017;5:291.
  28. The National Heart, Lung, and Blood Institute PETAL Clinical Trials Network. Early neuromuscular blockade in acute respiratory distress syndrome. NEJM 2019;380:1997-2008.
  29. Tobin A, Kelly W. Prone ventilation-it's time. Anaesth Intensive Care 1999;27:194-201
  30. Guerin C, Reignier J, Richard JC, Beuret P, Gacouin A, Boulain T, et al. Prone position in severe acute respiratory syndrome. N Engl J Med 2013;368:2159-68.
  31. Kenn S, Weber-Carstens S, Weizsaecker K, Bercker S. Prone positioning for ARDS following blunt chest trauma in late pregnancy. Int J Obstet Anesth 2009;18:268-71.
  32. Samanta S, Samanta S, Wig J, Baronia AK. How safe is the prone position in acute respiratory distress syndrome at late pregnancy? Am J Emerg Med 2014;32:687.e1-3.
  33. Karam O, Gebistorf F, Wetterslev J, Afshari A. The effect of inhaled nitric oxide in acute respiratory distress syndrome in children and adults: A Cochrane Systematic Review with trial sequential analysis. Anaesthesia 2017;72:106-17.
  34. Robinson JN, Banerjee R, Landzberg MJ, Thiet MP. Inhaled nitric oxide therapy in pregnancy complicated by pulmonary hypertension. Am J Obstet Gynecol 1999;180:1045-6.
  35. Netteburg D, Bsat F, Healy A, Markenson G, Plevyak M, Circeo L. The use of high-frequency oscillatory ventilation in a patient with H1N1 pneumonia. J Matern Fetal Neonatal Med 2011;24:264-6.
  36. Sharma NS, Wille KM, Bellot SC, Diaz-Guzman E. Modern use of extracorporeal life support in pregnancy and postpartum. ASAIO J 2015;61:110-4.
  37. Nair P, Davies AR, Beca J, Bellomo R, Ellwood D, Forrest P, et al. Extracorporeal membrane oxygenation for severe ARDS in pregnant and postpartum women during the 2009 H1N1 pandemic. Intensive Care Med 2011;37:648-54.
  38. Moore SA, Dietl CA, Coleman DM. Extracorporeal life support during pregnancy. J Thorac Cardiovasc Surg 2016;151:1154-60.
  39. Bonham CA, Patterson KC, Strek ME. Asthma Outcomes and Management During Pregnancy. Chest 2018;153:515-27.
  40. Fernandes AB, Zin WA, Rocco PR. Corticosteroids in acute respiratory distress syndrome. Braz J Med Biol Res 2005;38:147-59.
  41. Annane D, Pastores SM, Rochwerg B, Arlt W, Balk RA, Beishuizen A, et al. Guidelines for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in critically ill patients (Part I): Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017. Intensive Care Med 2017;43:1751-63.
  42. Bellani G, Laffey JG, Pham T, Fan E, Brochard L, Esteban A, et al. Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries. JAMA 2016;315:788-800.
  43. Rush B, Martinka P, Kilb B, McDermid RC, Boyd JH, Celi LA. Acute respiratory distress syndrome in pregnant women. Obstet Gynecol 2017;129:530-5.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.