title: Exacerbation of underlying pulmonary disease in pregnancy.
abstract: OBJECTIVE
  The presence of underlying pulmonary disease in women of childbearing potential can present a significant challenge during pregnancy and the postpartum period. Management of the underlying disease, recognizing and preventing disease progression, and, most important, managing and minimizing toxic side effects of various therapies require the expertise of an interdisciplinary team. This team must involve close collaboration between intensive care physicians, pulmonary physicians, and high-risk obstetricians familiar with these disease states in an effort to minimize fetal and maternal morbidity and mortality. We will review the impact of the pregnant state in lung transplant recipients, patients with pulmonary arterial hypertension, and patients with underlying cystic fibrosis.
  
  
  METHODS
  Review of the literature in regards to pregnancy outcomes and issues for patients with cystic fibrosis, pulmonary hypertension, and lung transplants.
  
  
  METHODS
  A review of the epidemiology, pathophysiology, risk factors, classification, clinical features, and outcomes for pregnant patients with underlying pulmonary diseases.
  
  
  CONCLUSIONS
  Safety of pregnancy in the female lung transplant recipient concerns three outcomes: maternal outcome, fetal outcome, and transplanted graft outcome.
authors.affiliation: Lung Transplantation Program, Department of Allergy, Pulmonary, and Critical Care Medicine, The Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Marie M
authors.initials: MM
authors.lastname: Budev
authors.forename: Alejandro C
authors.initials: AC
authors.lastname: Arroliga
authors.forename: Stephen
authors.initials: S
authors.lastname: Emery
mesh_terms: D003422:Critical Care; D003550:Cystic Fibrosis / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000503:physiopathology / Q000628:therapy; D008171:Lung Diseases / Q000503:physiopathology* / Q000628:therapy*; D016040:Lung Transplantation; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology* / Q000628:therapy*; D011256:Pregnancy Outcome