Characteristics and pregnancy outcomes of patients with severe pneumonia complicating pregnancy: a retrospective study of 12 cases and a literature review

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septic shock 2 infectiousdiseases
tuberculosis 6 infectiousdiseases
ganciclovir 1 infectiousdiseasesdrugs
pneumonia 50 infectiousdiseases

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ganciclovir 10036 such as beta-lactams, macrolides, or fluoroquinolones. Antiviral medications, namely, oseltamivir, ganciclovir or acyclovir, were administered to 7 patients (58%). Standard anti-tuberculosis therapy was initiated
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pneumonia 98 Title: BMC Pregnancy and ChildbirthCharacteristics and pregnancy outcomes of patients with severe pneumonia complicating pregnancy: a retrospective study of 12 cases and a literature reviewPingping TangJiangshan
pneumonia 496 to be associated with increased maternal and fetal morbidity and mortality. The management of severe pneumonia in gravid patients is even more challenging. Thus, we summarized the characteristics and pregnancy outcomes
pneumonia 698 pregnancy outcomes of these patients and explored the probable risk factors and predictive factors for pneumonia during pregnancy and the appropriate timing of delivery in severe pneumonia patients.MethodsA retrospective
pneumonia 774 predictive factors for pneumonia during pregnancy and the appropriate timing of delivery in severe pneumonia patients.MethodsA retrospective cohort study was conducted with 12 patients who were diagnosed with
pneumonia 891 patients.MethodsA retrospective cohort study was conducted with 12 patients who were diagnosed with severe pneumonia complicating pregnancy at Peking Union Medical College Hospital between January 2010 and June 2017.
pneumonia 1861 newborns.ConclusionsAnemia, advanced gestational age, and preeclampsia might be associated with the severity of pneumonia . Chest radiographs should be taken as soon as pneumonia is highly suspected to facilitate an early diagnosis.
pneumonia 1917 preeclampsia might be associated with the severity of pneumonia. Chest radiographs should be taken as soon as pneumonia is highly suspected to facilitate an early diagnosis. High incidences of adverse fetal outcomes were
pneumonia 2407 most common cause of fatal nonobstetric infections in pregnant patients [[1]]. In the United States, pneumonia complicates approximately 1 per 1000 pregnancies [[2]]. In Taiwan, pneumonia complicates 6.7 per 1000
pneumonia 2484 In the United States, pneumonia complicates approximately 1 per 1000 pregnancies [[2]]. In Taiwan, pneumonia complicates 6.7 per 1000 pregnancies [[3]]. In mainland China, this rate may be even higher. A true
pneumonia 2630 [[3]]. In mainland China, this rate may be even higher. A true estimate of the incidence of severe pneumonia during pregnancy is difficult to obtain because the few published studies in this area are mostly case
pneumonia 2920 both patients and their physicians tend to postpone radiation examinations and medical treatment when pneumonia is suspected. As a result, delayed diagnoses and referral are common in patients with pneumonia complicating
pneumonia 3016 when pneumonia is suspected. As a result, delayed diagnoses and referral are common in patients with pneumonia complicating pregnancy [[2]]. Several physiological and immunological changes that are experienced during
pneumonia 3371 compliance, and increased risk of aspiration, may predispose pregnant women to a more severe course of pneumonia , which may result in greater maternal and fetal morbidity and mortality [[1], [4]].A meta-analysis revealed
pneumonia 3694 influenza infection in nonpregnant individuals [[5]]. Early recognition and prompt treatment of severe pneumonia are essential to improve maternal and perinatal outcomes [[6]]. Because of the complexity of such cases
pneumonia 3996 this area, and few high-quality studies with large samples for the diagnosis and treatment of severe pneumonia during pregnancy have been published. Herein, we report a series of twelve gravid patients with severe
pneumonia 4109 during pregnancy have been published. Herein, we report a series of twelve gravid patients with severe pneumonia who were treated at a single institution. Both the clinical features and the maternal-fetal outcomes
pneumonia 4545 Beijing, China. We searched the medical records of PUMCH to identify patients who were diagnosed with pneumonia complicating pregnancy between January 2010 and June 2017. We found 51 such patients. The patients’
pneumonia 4795 presentation, laboratory tests, and treatment strategies were reviewed carefully to screen for severe pneumonia . Severe pneumonia was defined according to the American Thoracic Society guidelines for the management
pneumonia 4813 laboratory tests, and treatment strategies were reviewed carefully to screen for severe pneumonia. Severe pneumonia was defined according to the American Thoracic Society guidelines for the management of adults with
pneumonia 4942 according to the American Thoracic Society guidelines for the management of adults with community-acquired pneumonia as the presence of either one of two major criteria or two of three minor criteria. The major criteria
pneumonia 5444 recovered soon after preliminary treatment. Ultimately, 12 gravid patients who were diagnosed with severe pneumonia were included. Their detailed data including demographic data, gestational age at diagnosis, symptoms,
pneumonia 5911 collected, they were organized into summary forms to indicate the points in common in patients with severe pneumonia .ResultsMaternal characteristics and diagnostic evaluationsA total of 12 pregnant women were diagnosed
pneumonia 6035 pneumonia.ResultsMaternal characteristics and diagnostic evaluationsA total of 12 pregnant women were diagnosed with severe pneumonia at PUMCH during our study period (Table 1). The maternal age ranged between 18 and 36 years, with
pneumonia 8569 The two patients with the lowest PaO2/FiO2 ratio both died. Routine screening tests for the causative pneumonia pathogen, such as sputum culture, blood culture, nasal and throat swabs, and serologic testing, were
pneumonia 8785 carried out in 11 patients (except for patient 8). Tuberculosis was diagnosed in two patients, and viral pneumonia was diagnosed in three patients; the pathogenic virus was confirmed to be H1N1, H7N9, and respiratory
pneumonia 12482 patients (patients 1, 3, and 4) chose to terminate their pregnancies after they had recovered from pneumonia for social reasons. Patient 2 experienced intrauterine fetal death and spontaneous miscarriage 40 days
pneumonia 12624 experienced intrauterine fetal death and spontaneous miscarriage 40 days after the diagnosis of H7N9 pneumonia . After the miscarriage, the progression of multiple organ dysfunction syndrome (MODS) ceased, and she
pneumonia 13257 from 31 weeks to 38 weeks, underwent emergency Cesarean section as soon as the diagnosis of severe pneumonia was made. After delivery, the ventilator settings were downregulated for 4 patients, but for patient
pneumonia 13385 delivery, the ventilator settings were downregulated for 4 patients, but for patient 11, who had H1N1 pneumonia , no improvement was observed. Although ECMO was used, her cardiorespiratory condition worsened, and
pneumonia 13655 asphyxia (Apgar score of 7 at 1 min) but recovered well after primary resuscitation.DiscussionThe risk of pneumonia during pregnancy appears to be lowest during the first trimester [[2]]. Advanced gestational age has
pneumonia 13824 trimester [[2]]. Advanced gestational age has been proven to be an independent maternal risk factor for pneumonia [[6]]. Other risk factors for pneumonia in pregnancy include anemia, asthma, smoking, and the use of
pneumonia 13864 has been proven to be an independent maternal risk factor for pneumonia [[6]]. Other risk factors for pneumonia in pregnancy include anemia, asthma, smoking, and the use of antepartum corticosteroids and tocolytic
pneumonia 14363 findings highlighted the possibility of anemia and advanced gestational age as risk factors for severe pneumonia .Twenty-five percent of our patients (3/12) had severe preeclampsia, which is much higher than reported
pneumonia 14598 preeclampsia of 0.49% in China [[11]]. Romanyuk et al. and Chen et al. also reported that women with pneumonia had a higher prevalence of preeclampsia/eclampsia than women without pneumonia [[3], [12]]. This increased
pneumonia 14677 reported that women with pneumonia had a higher prevalence of preeclampsia/eclampsia than women without pneumonia [[3], [12]]. This increased incidence of preeclampsia/eclampsia might be the result of the pathophysiological
pneumonia 14821 incidence of preeclampsia/eclampsia might be the result of the pathophysiological changes associated with pneumonia . Severe pneumonia is characterized by hypoxemia, which subsequently causes placental hypoxia. The hypoxic
pneumonia 14839 preeclampsia/eclampsia might be the result of the pathophysiological changes associated with pneumonia. Severe pneumonia is characterized by hypoxemia, which subsequently causes placental hypoxia. The hypoxic placenta releases
pneumonia 15607 that the pulmonary edema caused by severe preeclampsia aggravates the oxygen desaturation caused by pneumonia , predisposing the patient to require a mechanical ventilator. Preeclampsia complicated with pneumonia
pneumonia 15709 pneumonia, predisposing the patient to require a mechanical ventilator. Preeclampsia complicated with pneumonia may be an unfavorable predictive factor for a poor maternal outcome.Initial misdiagnosis in pregnant
pneumonia 16146 easy to distinguish between symptoms related to physiological changes and more sinister symptoms of pneumonia during pregnancy. Patient 12 in this case series attended regular antenatal care visits at our hospital;
pneumonia 16278 Patient 12 in this case series attended regular antenatal care visits at our hospital; this patient’s pneumonia began with the symptoms of a common cold. Three days later, when she developed dyspnea, labor started.
pneumonia 16502 respiratory symptoms were intermixed with the discomfort of labor pain. This made the early recognition of pneumonia more difficult. It must be emphasized that close observation is very important; chest radiography should
pneumonia 16665 observation is very important; chest radiography should never be withheld from a pregnant woman in whom pneumonia is suspected since the radiation exposure through even multiple diagnostic X-ray procedures or chest
pneumonia 17462 were continued in 4 patients during 18 to 25 weeks of gestation; the 4 mothers all recovered from pneumonia , but one of them had a spontaneous miscarriage 40 days after the onset of illness. The other 3 pregnancies
pneumonia 17710 fetuses were discharged from the hospital. Chang et al. and Liao et al. also reported cases of atypical pneumonia requiring mechanical ventilation during the second trimester without complications to either the mother
pneumonia 18054 requirements within 24 h [[17]], and since there is a high rate of adverse pregnancy outcomes in maternal pneumonia [[3], [20]], most case series in the literature suggest an expeditious delivery after 28 weeks of gestation
pneumonia 18346 after 28 weeks of gestation with live fetuses underwent delivery soon after the diagnosis of severe pneumonia was made. Their fetal and maternal outcomes were mostly good, except for one neonatal death (patient
pneumonia 18934 should be taken into account when interpreting the results of the study.ConclusionsIn conclusion, severe pneumonia complicating pregnancy was associated with high maternal morbidity and mortality. High incidences of
pneumonia 19241 also observed. Anemia, advanced gestational age, and preeclampsia were associated with the severity of pneumonia . Patients with dyspnea, fever and chest pain should be evaluated carefully; chest radiographs should
pneumonia 19383 and chest pain should be evaluated carefully; chest radiographs should be taken when the diagnosis of pneumonia is highly suspected. Termination of pregnancy is recommended when respiratory function deteriorates
septic shock 5103 or two of three minor criteria. The major criteria include the need for mechanical ventilation and septic shock . The minor criteria include systolic blood pressure ≤ 90 mmHg, multilobar infiltrates, and PaO2/FIO2
septic shock 11156 remaining ten patients recovered well. The major complications observed among these patients included septic shock (5/12, 42%), adult respiratory distress syndrome (5/12, 42%), liver failure (4/12, 33%), acute renal
tuberculosis 6768 membranous nephropathy but was cured 2 years prior to becoming pregnant. Patient 3 had a history of tuberculosis . Patient 7 had a history of severe preeclampsia during her last pregnancy. Patient 8 had chronic hypertension.
tuberculosis 7805 (d)876872354710464NA Pathogen–H7N9TB–TB–––––H1N1RSVNANA not applicable, GA gestational age, CXR chest X-ray, CT computed tomography, TB tuberculosis , RSV respiratory syncytial virusAll patients had high fevers (> 38 °C) and dyspnea. Eight patients
tuberculosis 9466 at 68 and 23 days, respectively. Interestingly, the final diagnoses of these two patients were both tuberculosis .TreatmentAll patients were admitted to the intensive care unit (ICU) because of severe hypoxemia (Table 2).
tuberculosis 10115 namely, oseltamivir, ganciclovir or acyclovir, were administered to 7 patients (58%). Standard anti- tuberculosis therapy was initiated in patient 3 and patient 5 as soon as tuberculosis was diagnosed. Intravenous
tuberculosis 10188 patients (58%). Standard anti-tuberculosis therapy was initiated in patient 3 and patient 5 as soon as tuberculosis was diagnosed. Intravenous courses of pulsed methylprednisolone were administered to 8 patients (67%).
tuberculosis 10841 (d)–18––––––––12–NAMedication Antibiotics++++++++++++12/12(100) Antivirals+++–––+––+++7/12(58) Anti-TB––+–+––––––+2/12(17) GC+++++–––++–+8/12(67) IVIG–+–––––––+++4/12(33)ICU intensive care unit, ECMO extracorporeal membrane oxygenation, TB tuberculosis , GC, glucocorticoids, IVIG intravenous immunoglobinComplications and outcomesTwo of these patients (patient

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