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[Pneumomediastinum related to the second stage of labour - a report on 2 cases].
Z Geburtshilfe Neonatol. 2014 Jun; 218(3):128-30.ZG

Abstract

We report on 2 primigravidae developing pneumomediastinum and subcutaneous emphysema associated with the second stage of labor. Both of the newborns had a comparatively high birth-weight (3,855 g and 4,245 g, respectively). In the first case, the patient felt a sudden chest pain during expulsion followed by dyspnea and swelling of the face. The birth was terminated by vacuum extraction. In the second case, a mild shoulder dystocia occurred, which could be resolved by McRoberts maneuver. The patient exhibited a swollen face and shortness of breath on the first postpartum day. Physical examination revealed crackly skin over the lower face, both sides of the neck and the front of the chest. In both cases, CT scan of the chest revealed pneumomediastinum and a subcutaneous emphysema of the upper thorax, however without showing a pneumothorax. The first patient underwent bronchoscopy and esophagogastroduodenoscopy; there were no abnormalities detected. The pneumomediastinum and subcutaneous emphysema gradually diminished spontaneously in both cases. Appropriate pain management and empirical antibiotics were applied. Pneumomediastinum during labor and birth, typically with subcutaneous emphysema in the face and neck, is a rare condition, but there are reported cases in the literature. Based on the limited available evidence, it seems to have a benign, self-limiting course. A conservative management appears -appropriate and sufficient.

Authors+Show Affiliations

Frauenklinik, Universitätsklinik Freiburg, Freiburg.Frauenklinik, Universitätsklinik Freiburg, Freiburg.Frauenklinik, Universitätsklinik Freiburg, Freiburg.Pneumonologie, Medizinische Universitätsklinik, Freiburg.Frauenklinik, Universitätsklinik Freiburg, Freiburg.Frauenklinik, Universitätsklinik Freiburg, Freiburg.

Pub Type(s)

Case Reports
English Abstract
Journal Article

Language

ger

PubMed ID

24999791

Citation

Rasenack, R, et al. "[Pneumomediastinum Related to the Second Stage of Labour - a Report On 2 Cases]." Zeitschrift Fur Geburtshilfe Und Neonatologie, vol. 218, no. 3, 2014, pp. 128-30.
Rasenack R, Lambers K, Gaupp N, et al. [Pneumomediastinum related to the second stage of labour - a report on 2 cases]. Z Geburtshilfe Neonatol. 2014;218(3):128-30.
Rasenack, R., Lambers, K., Gaupp, N., Kabitz, H. J., Kunze, M., & Prömpeler, H. (2014). [Pneumomediastinum related to the second stage of labour - a report on 2 cases]. Zeitschrift Fur Geburtshilfe Und Neonatologie, 218(3), 128-30. https://doi.org/10.1055/s-0034-1376991
Rasenack R, et al. [Pneumomediastinum Related to the Second Stage of Labour - a Report On 2 Cases]. Z Geburtshilfe Neonatol. 2014;218(3):128-30. PubMed PMID: 24999791.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Pneumomediastinum related to the second stage of labour - a report on 2 cases]. AU - Rasenack,R, AU - Lambers,K, AU - Gaupp,N, AU - Kabitz,H-J, AU - Kunze,M, AU - Prömpeler,H, Y1 - 2014/07/07/ PY - 2014/7/8/entrez PY - 2014/7/8/pubmed PY - 2015/8/20/medline SP - 128 EP - 30 JF - Zeitschrift fur Geburtshilfe und Neonatologie JO - Z Geburtshilfe Neonatol VL - 218 IS - 3 N2 - We report on 2 primigravidae developing pneumomediastinum and subcutaneous emphysema associated with the second stage of labor. Both of the newborns had a comparatively high birth-weight (3,855 g and 4,245 g, respectively). In the first case, the patient felt a sudden chest pain during expulsion followed by dyspnea and swelling of the face. The birth was terminated by vacuum extraction. In the second case, a mild shoulder dystocia occurred, which could be resolved by McRoberts maneuver. The patient exhibited a swollen face and shortness of breath on the first postpartum day. Physical examination revealed crackly skin over the lower face, both sides of the neck and the front of the chest. In both cases, CT scan of the chest revealed pneumomediastinum and a subcutaneous emphysema of the upper thorax, however without showing a pneumothorax. The first patient underwent bronchoscopy and esophagogastroduodenoscopy; there were no abnormalities detected. The pneumomediastinum and subcutaneous emphysema gradually diminished spontaneously in both cases. Appropriate pain management and empirical antibiotics were applied. Pneumomediastinum during labor and birth, typically with subcutaneous emphysema in the face and neck, is a rare condition, but there are reported cases in the literature. Based on the limited available evidence, it seems to have a benign, self-limiting course. A conservative management appears -appropriate and sufficient. SN - 1439-1651 UR - https://www.unboundmedicine.com/medline/citation/24999791/[Pneumomediastinum_related_to_the_second_stage_of_labour___a_report_on_2_cases]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0034-1376991 DB - PRIME DP - Unbound Medicine ER -