title: Spontaneous pneumothorax in the third trimester of pregnancy.
abstract: The present report concerns a young woman previously diagnosed as having childhood asthma who presented with a secondary spontaneous pneumothorax during the third trimester of pregnancy; at term a caesarean section was recommended for safety reasons. Post partum a severe fixed ventilatory defect unresponsive to inhaled bronchodilator and a short oral course of steroids ruled out asthma. Diffuse bronchiectasis was found on her chest CT scan, although this was not evident clinically. Known aetiologies for diffuse bronchiectasis (cystic fibrosis, anti-α1 antitrypsin deficiency, rheumatic diseases, mycobacterial infections, childhood infections and immune deficiencies) were ruled out. Therefore it is believed her bronchiectasis was idiopathic or congenital. No recommendations from recent guidelines on how to manage labour in a woman after a spontaneous pneumothorax could be found. However, a literature search revealed that pregnant women usually experience primary pneumothorax and may continue in natural labour; however, it is unknown how best to manage a woman with secondary spontaneous pneumothorax.
authors.affiliation: Soroka University Medical Center, PO Box 151, Beer-Sheva, 84101, Israel.
authors.forename: Abriel
authors.initials: A
authors.lastname: Avital
authors.forename: Ori
authors.initials: O
authors.lastname: Galante
authors.forename: Joel
authors.initials: J
authors.lastname: Baron
authors.forename: Alexander
authors.initials: A
authors.lastname: Smoliakov
authors.forename: Dov
authors.initials: D
authors.lastname: Heimer
authors.forename: Lone S
authors.initials: LS
authors.lastname: Avnun
references.citation: Chest. 2000 May;117(5):1279-85
references.pmid: 10807811
references.citation: N Engl J Med. 2000 Mar 23;342(12):868-74
references.pmid: 10727592
references.citation: Eur Respir J. 2008 Feb;31(2):396-406
references.pmid: 18238949
references.citation: Chest. 2007 Sep;132(3):1044-8
references.pmid: 17873199
references.citation: J Accid Emerg Med. 1994 Dec;11(4):234-7
references.pmid: 7894809
references.citation: Thorax. 2003 May;58 Suppl 2:ii39-52
references.pmid: 12728149
references.citation: Chest. 2008 Oct;134(4):815-823
references.pmid: 18842914