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Pulmonary Diseases in Pregnancy

Pulmonary Diseases in Pregnancy. Ma. Asuncion A. Fernandez, MD, FPOGS, FPSREI St. Luke’s College of Medicine WHQuasha Memorial November 9, 2009. Outline.

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Pulmonary Diseases in Pregnancy

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  1. Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD, FPOGS, FPSREI St. Luke’s College of Medicine WHQuasha Memorial November 9, 2009

  2. Outline Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 2

  3. Physiologic conditions Ma. Asuncion A. Fernandez, MD, FPOGS, FPSREI St. Luke’s College of Medicine WHQuasha Memorial November 9, 2009

  4. Physiologic changes RV + ERV = FRC Except for residual volume and lung capacities derived therefrom, the ‘s can be measured using direct spirometric techniques. Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 4

  5. Physiologic changes Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 5

  6. Unclear condition Ma. Asuncion A. Fernandez, MD, FPOGS, FPSREI St. Luke’s College of Medicine WHQuasha Memorial November 9, 2009

  7. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 7

  8. Usual conditions Ma. Asuncion A. Fernandez, MD, FPOGS, FPSREI St. Luke’s College of Medicine WHQuasha Memorial November 9, 2009

  9. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 9

  10. unclear, usual, ubiquitous Complication: Preterm labor20 poorly tolerated fetal hypoxemia and acidosis Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 10

  11. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 11

  12. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 12

  13. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 13

  14. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 14

  15. unclear, usual, ubiquitous Viral Pneumonia Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 15

  16. unclear, usual, ubiquitous Viral Pneumonia Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 16

  17. unclear, usual, ubiquitous Viral Pneumonia Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 17

  18. unclear, usual, ubiquitous Viral Pneumonia Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 18

  19. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 19

  20. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 20

  21. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 21

  22. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 22

  23. unclear, usual, ubiquitous Barth & Harkins Modification 1991 Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 23

  24. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 24

  25. unclear, usual, ubiquitous An FEV1 <1 L, <20% of that predicted,= severe disease = hypoxia, poor response to therapy, high relapse rate. Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 25

  26. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 26

  27. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 27

  28. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 28

  29. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 29

  30. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 30

  31. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 31

  32. unclear, usual, ubiquitous • 1st 2 mos • 9 mos Streptomycin : Category X in pregnancy: auditory, vestibular abnormalities, severe deafness Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 32

  33. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 33

  34. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 34

  35. unclear, usual, ubiquitous Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 35

  36. Ubiquitous condition Ma. Asuncion A. Fernandez, MD, FPOGS, FPSREI St. Luke’s College of Medicine WHQuasha Memorial November 9, 2009

  37. unclear, usual, ubiquitous Half life of CO Rm temp=4-6 hrs 100% O2=1 hour Hyperbaric O2=15- 30 mins Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 37

  38. Lay back, Launch, Limit care Ma. Asuncion A. Fernandez, MD, FPOGS, FPSREI St. Luke’s College of Medicine WHQuasha Memorial November 9, 2009

  39. Lay back, launch or limit care? Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 39

  40. Lay back, launch or limit care? Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 40

  41. Model case Ma. Asuncion A. Fernandez, MD, FPOGS, FPSREI St. Luke’s College of Medicine WHQuasha Memorial November 9, 2009

  42. Model case M.O. 31 y/o G2P1 10 weeks AOG No cough or hemoptysis Asymptomatic Referred by pulmo: CXR: (+) PTB, activity ? Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 42

  43. Outcome Ma. Asuncion A. Fernandez, MD, FPOGS, FPSREI St. Luke’s College of Medicine WHQuasha Memorial November 9, 2009

  44. outcome Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD 44

  45. Pulmonary Diseases in Pregnancy Ma. Asuncion A. Fernandez, MD, FPOGS, FPSREI St. Luke’s College of Medicine WHQuasha Memorial November 9, 2009

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