RT Book, Section
A1 Tonidandel, Ashley M.
A1 Booth, Jessica L.
A2 Santos, Alan C.
A2 Epstein, Jonathan N.
A2 Chaudhuri, Kallol
SR Print(0)
ID 1108524496
T1 Anesthetic Management of the Parturient With Respiratory Disease
T2 Obstetric Anesthesia
YR 2015
FD 2015
PB McGraw-Hill Education
PP New York, NY
SN 9780071786133
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1108524496
RD 2024/04/25
AB A  majority  of  women  experience  subjective  breathlessness  during  pregnancy.  This  complicates  the  diagnosis  of  true  respiratory  pathology.  “Dyspnea  of  pregnancy”  is  likely  related  to  normal  physiologic  alterations,  summarized  in  Table  26-1,  that  serve  to  maintain  the  fetus  and  prepare  the  mother  for  labor  and  delivery.1  The  dyspnea  associated  with  pregnancy  does  not  interfere  with  activities  of  daily  living  and  is  not  related  to  exertion,  coughing,  or  wheezing.  Physiologic  dyspnea  usually  improves  as  pregnancy  progresses,  particularly  with  “quickening,”  which  is  defined  as  the  maternal  perception  of  initial  fetal  movement.  In  contrast,  pathologic  dyspnea  from  cardiac  or  pulmonary  origins  may  have  an  abrupt  onset,  be  progressive  in  its  severity,  occur  even  at  rest,  or  be  associated  with  cough,  chest  pain,  fever,  or  hemoptysis.  Dyspnea  due  to  cardiac  or  respiratory  pathology  worsens  as  the  pregnancy  reaches  the  third  trimester.  Pregnant  women  with  a  respiratory  rate  greater  than  20  breaths/min,  increased  work  of  breathing,  or  the  presence  of  rales,  wheezing,  or  murmurs  deserve  prompt  evaluation  for  potential  cardiopulmonary  pathology.2