title: Hamman's syndrome (spontaneous pneumomediastinum) in a parturient: a case report.
abstract: BACKGROUND
  Subcutaneous emphysema and pneumomediastinum in labour and delivery is a rare but potentially serious occurrence that must be identified and managed appropriately to avoid unnecessary investigations and interventions. Published reports indicate that subsequent pregnancies pose no additional risk for recurrence.
  
  
  METHODS
  A 27-year-old primiparous patient with an uneventful pregnancy and delivery developed subcutaneous emphysema but remained stable clinically. Chest radiography confirmed a pneumomediastinum. She was managed conservatively with supportive measures and anxiolytics and showed complete resolution after five days. A future pregnancy is planned.
  
  
  CONCLUSIONS
  Recognition of spontaneous pneumomediastinum and its potential consequences during labour and delivery requires vigilance. Supportive measures alone may be the only requirement for resolution. Recurrence of the condition is rare, but the appropriate management of subsequent pregnancies is unclear. Expectant management with epidural analgesia to minimize active pushing is suggested in a subsequent spontaneous vaginal delivery.
authors.affiliation: Department of Family Medicine, Northeastern Ontario Family Medicine Program, Faculty of Medicine, University of Ottawa, Ottawa ON.
authors.forename: Miguel Marc
authors.initials: MM
authors.lastname: Bonin
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008478:Mediastinal Emphysema / Q000150:complications* / Q000000981:diagnostic imaging; D007744:Obstetric Labor Complications / Q000000981:diagnostic imaging; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D011859:Radiography; D013352:Subcutaneous Emphysema / Q000150:complications* / Q000000981:diagnostic imaging; D013577:Syndrome