Maternal Pulmonary Function Research Articles

Varied Reproductive Histories of Ethnically Tibetan Women.

The U.N. health and well-being goals for 2030 focus on maternal and child health outcomes, among others. Challenges to meeting those goals vary widely throughout Nepal owing to the range of sociocultural factors, infrastructural limitations, physical geography and altitudes. This article explores sociocultural and biological influences on fertility and child survival among ethnically Tibetan women in Nepal. This is a cross sectional study of 430 women, age 46-86 years old, citizens of Nepal and native residents above 3500m in Mustang District, who provided interview and physiological data. Univariate Poisson regression analyses selected significant variables to include in multivariate Poisson regressions investigating the number of pregnancies, livebirths, child survival and death outcomes. Earlier age at first pregnancy, later age at last pregnancy, and miscarriages associated with more pregnancies. Miscarriages and stillbirths associated with fewer livebirths. Higher maternal BMI and FEV6 associated with fewer children dying before age 15. Marital characteristics (status, type, continuity), contraceptive use, relative wealth, and education influenced these covariates. Low maternal pulmonary function and nutritional status predict poorer child survival in Upper Mustang. Addressing poor lung function and nutrition may improve reproductive outcomes among ethnically Tibetan women living at high altitude.

The Effect of Maternal Pulmonary Function Test Parameters on Umbilical Cord Blood Gas and the Duration of Labor.

To evaluate the relationship between the maternal pulmonary function test (PFT) and the Apgar score of the newborn, umbilical cord blood (UCB) gas values and the duration of delivery. The present study included 41 volunteer nulliparous pregnant women who presented to our obstetrics clinic and PFTs were performed by using spirometry. A significant positive correlation was observed between 5th-minute Apgar scores and maternal FEV1 (forced expiratory volume in the first second) (lt), FEV1%, FVC (lt), FVC% (r=0.509, p=0.003; r=0.47, p=0.007; r=0.434, p=0.013; r=0.417, p=0.017; respectively). A significant positive correlation was observed between UCB pH value and maternal FEV1 (lt), FVC (lt) (r=0.515, p=0.003; r=0.351, p=0.049; respectively). Our results showed that FEV1 and FVC values, which indicate maternal respiratory functions, may affect Apgar scores of the newborn and UCB gas values.

Pulmonary effects of bupivacaine, ropivacaine, and levobupivacaine in parturients undergoing spinal anaesthesia for elective caesarean delivery: A randomised controlled study

Background Spinal anaesthesia is the method of choice for elective caesarean delivery, but has been reported to worsen dynamic pulmonary function when using bupivacaine. Similar investigations are lacking for ropivacaine and levobupivacaine. We have therefore compared the pulmonary effects of intrathecal bupivacaine, ropivacaine and levobupivacaine used for caesarean delivery. Methods Forced vital capacity, forced expiratory volume in the first second, and peak expiratory flow rate were measured in 48 parturients before and after onset of spinal anaesthesia using either 0.5% bupivacaine 10 mg, 1% ropivacaine 20 mg, or 0.5% levobupivacaine 10 mg. Apgar scores and umbilical arterial pH were recorded. Results The final level of sensory blockade was not different between groups. Forced vital capacity was significantly decreased with bupivacaine (3.6 ± 0.5 L to 3.5 ± 0.4 L, P < 0.05) and ropivacaine (3.2 ± 0.4 L to 3.1 ± 0.5 L, P < 0.05), but not with levobupivacaine (3.6 ± 0.5 L to 3.4 ± 0.6 L). Forced expiratory volume during the first second was not decreased in any group. Peak expiratory flow rate was significantly decreased with ropivacaine (5.5 ± 1.5 L/s to 5.0 ± 1.1 L/s, P < 0.05) and levobupivacaine (from 6.0 ± 1.1 L/s to 5.2 ± 0.9 L/s, P < 0.01). Neonatal vital parameters did not differ between the three groups. Conclusions Decreases in maternal pulmonary function tests were similar following spinal anaesthesia with bupivacaine, ropivacaine, or levobupivacaine for caesarean delivery. The clinical maternal and neonatal effects of these alterations appeared negligible.

Asthma in pregnancy.

Asthma, a chronic inflammatory disease of the airway system, is the most common respiratory complication that can impact pregnancy. Various physiologic changes in gestation may variably affect this pulmonary disease. The cornerstone of management involves implementing strategies and treatments that assist in maintaining normal maternal pulmonary function, thereby preventing fetal complications. Optimum therapy can provide a favorable outcome for both mother and fetus.

Chylothorax, chylopericardium and lymphoedema – the presenting features of signet-ring cell carcinoma

This case study describes a successful pregnancy in a 27-yr-old patient with severe emphysema, secondary to alpha1-antitrypsin deficiency, genotype PiZZ. Despite significant respiratory compromise, more severe than previously reported, no complications ensued. Maternal pulmonary function did not deteriorate significantly until the 32nd week of pregnancy, with an elective Caesarean section being performed during the 37th week. This experience suggests that even severe maternal airflow obstruction is, in itself, not an absolute contra-indication to pregnancy. Pre-pregnancy multidisciplinary counselling is likely to be helpful in these patients, including frank discussion on the risks of pregnancy, the prospects of successful completion and the mother9s future prognosis in relation to caring for the child.

The safety of asthma and allergy medications during pregnancy

Background: Although no asthma or allergy medications can be considered proven safe for use during pregnancy, these medications are often used to prevent the potential direct and indirect consequences of uncontrolled asthma or allergy. Objective: The safety of asthma medications, antihistamines, and decongestants was assessed in a prospectively monitored cohort of 824 pregnant women with and 678 pregnant women without asthma. Methods: Medications used since conception were recorded on each subject's initial visit (< 28 weeks' gestation). Thereafter, diary cards for medications were completed by the patient through the time of delivery. Perinatal outcomes were compared in exposed versus unexposed individuals. A multivariate analysis accounted for the potential effects of age, parity, smoking, race, weight gain during pregnancy, maternal pulmonary function, acute asthmatic episodes, and multiple medication exposure. Results: No significant relationships were identified between major congenital malformations and first trimester or any exposure to β-agonists, theophylline, cromolyn, corticosteroids, antihistamines, or decongestants. In the multivariate analyses, oral corticosteroids were independently associated with preeclampsia (odds ratio = 2.0, p = 0.027), but no other independent associations were observed between asthma or allergy medications and adverse perinatal outcomes. Conclusion: Use of most common asthma and allergy medications during pregnancy was not associated with increased perinatal risks. Maternal use of oral corticosteroids was independently associated with the occurrence of preeclampsia in this study, although the mechanism of this association is not clear. However, because prior observations suggest that severe asthma may be associated with maternal and/or fetal mortality, risk-benefit considerations still favor the use of oral corticosteroids when indicated for the treatment of asthma during pregnancy. (J Allergy Clin Immunol 1997;100:301-6.)

Pregnancy outcome in mothers with cystic fibrosis: normal neonatal immune responses.

Although pregnancy with cystic fibrosis (CF) has been associated in previous reports with increased maternal and neonatal morbidity, this may not reflect the current outcome with intense perinatal medical support. This report describes the pregnancy and pregnancy outcome in four women with CF. Although one neonate was delivered prematurely to a mother with advanced CF, there were no developmental abnormalities. The one premature infant was appropriately developed for his gestational age. Maternal pulmonary function was not clearly influenced by pregnancy, as confirmed by similar Schwachman scores before conception and after delivery. Finally, in this series of patients the postdelivery Schwachman score could be predicted from the preconception score.