Cesarean delivery for life-threatening status asthmaticus.
BACKGROUND
Asthma remains a common chronic illness in pregnancy with the potential for catastrophic complications. Most women with asthma exacerbation can be treated with medical management and continuation of pregnancy. However, refractory cases may necessitate delivery for fetal or maternal indications.


METHODS
We report a case of status asthmaticus at 33 weeks of gestation with significant maternal respiratory acidosis and difficulty with ventilation necessitating delivery by cesarean delivery in the medical intensive care unit. The patient was unresponsive to standard medical therapies. Delivery resulted in immediate improvement in maternal ventilation parameters.


CONCLUSIONS
In cases of life-threatening status asthmaticus refractory to standard medical and ventilatory therapies in the third trimester, cesarean delivery should be considered as a final effort to increase tidal volumes and improve maternal gas exchange.
Department of Obstetrics and Gynecology, University of Utah, Salt Lake, Utah, USA. Loj@ohsu.edu
Jamie O
JO
Lo
Jonathan
J
Boltax
Torri D
TD
Metz
D000142:Acidosis, Respiratory / Q000209:etiology / Q000503:physiopathology*; D000328:Adult; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000503:physiopathology*; D013224:Status Asthmaticus / Q000150:complications / Q000503:physiopathology*; D013990:Tidal Volume