Progressive intrapartum respiratory insufficiency due to pulmonary alveolar proteinosis. Amelioration by therapeutic whole-lung bronchopulmonary lavage.
A 23-year-old woman became pregnant in the setting of long-standing severe pulmonary alveolar proteinosis. A previous twin gestation had resulted in low birth-weight infants. Progressive clinical and respiratory deterioration occurred, associated with exertional arterial oxygen desaturation. Because of the severity of her physiologic derangements and concern for the fetus, whole-lung bronchopulmonary lavage was performed twice under controlled conditions. This resulted in subjective and objective improvement, followed by successful term delivery.
D000328:Adult; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000150:complications; D008176:Lung Volume Measurements; D010100:Oxygen / Q000097:blood; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D011649:Pulmonary Alveolar Proteinosis / Q000150:complications* / Q000628:therapy; D012123:Pulmonary Ventilation; D011859:Radiography; D012131:Respiratory Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D007507:Therapeutic Irrigation
D010100:Oxygen