Factors implicated in the outcome of pregnancies complicated by acute respiratory failure.
OBJECTIVE
To investigate factors predictive of the outcome of acute respiratory failure during pregnancy.


METHODS
We retrospectively reviewed the records of all pregnant women diagnosed with acute respiratory failure at a tertiary referral center from January 1, 1995, to September 30, 2000. Maternal characteristics, etiology of respiratory failure and treatment were compared between survivors and nonsurvivors.


RESULTS
Twenty patients with acute respiratory failure were identified; 16 of them survived (mortality, 20%). Acute respiratory failure was diagnosed in the postpartum period in 16 (80%), and the majority of cases occurred in the first 2 postpartum days (93.8%). There was no statistically significant difference between the 2 groups in terms of patient characteristics, immediate precipitants of acute respiratory failure (including pneumonia, cardiogenic pulmonary edema, acute respiratory distress syndrome, asthma, pulmonary embolism and amniotic fluid embolism) and laboratory characteristics except for pH. However, patients who manifested disseminated intravascular coagulopathy (DIC) and sepsis as precipitating causes or complications of the immediate precipitating disease entities as well as initial loss of consciousness were predictive of poor maternal outcome.


CONCLUSIONS
The immediate etiology of acute respiratory failure is not predictive of maternal outcome, but lower pH, initial loss of consciousness, DIC and sepsis are risk factors for maternal mortality.
Chen
Chen-Yu
CY
Division of High Risk Pregnancy, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Graduate Institute of Nurse-Midwifery, National Taipei College of Nursing, Taipei, Taiwan.
Chen
Chie-Pein
CP
Wang
Kuo-Gon
KG
Kuo
Su-Chen
SC
Su
Tsung-Hsien
TH
D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D011256:Pregnancy Outcome; D011644:Puerperal Disorders / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D012138:Respiratory Therapy; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate