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Aspiration Pneumonitis Causing Respiratory Collapse in a Pregnant Patient Not in Labor

Westerfield, Katie L. DO; Bhavsar, Amit K. MD; Green, Samantha MD

doi: 10.1097/AOG.0000000000003486
Contents: Medical Complications of Pregnancy: Case Report
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BACKGROUND: Aspiration is a known risk of obstetric anesthesia; however; it has not been previously described outside of active labor or the setting of anesthesia.

CASE: We present the case of a 31-year-old patient with a twin gestation at 33 weeks of gestation, not in labor, with clinically silent aspiration leading to aspiration pneumonitis and respiratory collapse requiring endotracheal intubation and transport to a pulmonary critical care service. After 4 days, she was extubated and eventually underwent a cesarean delivery at 37 weeks of gestation with no long-term pulmonary sequelae.

CONCLUSION: Clinicians should consider aspiration pneumonitis in the gravid patient who develops acute shortness of breath, even in the absence of active labor or receipt of anesthesia.

This case describes a patient pregnant with twins, not in labor, who experienced respiratory collapse due to silent aspiration.

Uniformed Services University of the Health Sciences, F. Edward Hebert School of Medicine, Bethesda, Maryland.

Corresponding author: Katie L. Westerfield, DO, Department of Community and Family Medicine, Carl R. Darnall Army Medical Center, Fort Hood, TX; email: kwesterfield@atsu.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

The opinions and assertions contained herein are the private views of the authors and are not to be construed as the official policy or position of the Department of Defense or the U.S. government.

Each author has confirmed compliance with the journal's requirements for authorship.

Peer reviews and author correspondence are available at http://links.lww.com/AOG/B537.

© 2019 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.