title: Unsuspected 34-week pregnancy presenting as acute hypoxaemic respiratory failure.
abstract: An obese body habitus may interfere with diagnosis of potentially life-threatening conditions. This report describes an obese woman who presented with acute hypoxemic respiratory failure and diffuse infiltrates. Her body habitus disguised her parturient abdomen and she could not provide a history because she was intubated and paralysed. Only after a urine pregnancy test was undertaken did it become apparent that she was pregnant and the diagnosis of pre-eclampsia with pulmonary oedema was considered. Urine pregnancy tests are part of the standard work-up for abdominal pain in women of childbearing age, but are not viewed as part of the work-up for respiratory distress or diffuse radiographic infiltrates. This case illustrates the value of obtaining a pregnancy test in all women, particularly those with obese body habitus, who present with respiratory failure of unclear aetiology.
authors.affiliation: Pulmonary and Critical Care Medicine, University of Washington, 1959 NE Pacific Street, Box 356522, Seattle, WA 98195-6522, USA. aluks@u.washington.edu
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Luks
mesh_terms: D000208:Acute Disease; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009765:Obesity / Q000175:diagnosis*; D011225:Pre-Eclampsia / Q000175:diagnosis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011258:Pregnancy Tests; D011654:Pulmonary Edema / Q000175:diagnosis / Q000209:etiology; D012131:Respiratory Insufficiency / Q000209:etiology*