Abstract
ObjectiveTo describe management and clinical features observed in a patient's seven spontaneous pneumothoraces that developed during two consecutive pregnancies involving both hemithoraces.Materials and methodsA 21 year old former smoker developed three spontaneous left pneumothoraces in the index pregnancy, having already experienced four right pneumothorax events in a prior pregnancy at age 19.ResultsChest tubes were required in several (but not all) hospitalizations during these two pregnancies. Following her fourth right pneumothorax, thoracoscopic excision of right apical lung blebs and mechanical pleurodesis was performed. The series of left pneumothoraces culminated in mini-thoracotomy and thoracoscopically directed mechanical pleurodesis. For both pregnancies unassisted vaginal delivery was performed with no adverse perinatal sequelae. With the exception of multiple pneumothoraces, there were no additional pregnancy complications.ConclusionSpontaneous pneumothorax in pregnancy is believed to be a rare phenomenon, yet the exact incidence is unknown. Here we present the first known case of multiple spontaneous pneumothoraces in two consecutive pregnancies involving both hemithoraces. Clinical management coordinated with obstetrics and surgical teams facilitated a satisfactory outcome for both pregnancies. The diagnosis of pneumothorax should be contemplated in any pregnant patient with dyspnea and chest pain, followed by radiographic confirmation.
Highlights
Spontaneous pneumothorax in pregnancy is generally regarded as an unusual disorder, with only approximately 50 cases having been reported in the world literature
We describe diagnosis and treatment for a patient who experienced multiple pneumothoraces developing in two consecutive pregnancies
There was no history of trauma, coughing or sneezing episodes. She was brought to the emergency room where she was admitted with the diagnosis of right pneumothorax and a chest tube was placed
Summary
Spontaneous pneumothorax in pregnancy is generally regarded as an unusual disorder, with only approximately 50 cases having been reported in the world literature. We describe diagnosis and treatment for a patient who experienced multiple pneumothoraces developing in two consecutive pregnancies. Previous pregnancies Three years before initial presentation, a 19 year-old female experienced the first of seven spontaneous pneumothorax events. In the sixth week of her fifth pregnancy, she "felt sharp rightsided chest pain" radiating posteriorly accompanied by right arm paraesthesia and dyspnea. This developed while driving her car home. There was no history of trauma, coughing or sneezing episodes. She was brought to the emergency room where she was admitted with the diagnosis of right pneumothorax and a chest tube was placed. Good re-expansion was noted on chest x-ray and the patient was discharged home 2d later
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