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Semin Respir Crit Care Med 2017; 38(02): 123-134
DOI: 10.1055/s-0037-1602167
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

General Management Principles of the Pregnant Woman

Amanpreet Kaur
1   Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
,
Margaret Miller
2   Department of Medicine, Women's Medicine Collaborative, The Miriam Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
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Publication History

Publication Date:
22 May 2017 (online)

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Abstract

Pregnancy is a dynamic process that consists of profound physiological changes mediated by hormonal, mechanical, and circulatory pathways. Understanding of changes in physiology is essential for distinguishing abnormal and normal signs and symptoms in a pregnant patient. These physiological changes also have important pharmacotherapeutic considerations for a pregnant patient. Although there are limited data to guide decisions regarding medications and diagnostic procedures in pregnancy, a careful review of risks should be balanced with review of risk of withholding a medication or procedure. Interventional pulmonary procedures can be safely performed in pregnant women while keeping in mind the maternal anatomic and physiologic changes. Furthermore, management of a maternal cardiopulmonary arrest requires important modifications in patient positioning and intravenous access to ensure adequate efficacy of chest compressions, circulation, and airway management. This review will provide an overview of maternal physiologic changes with a focus on cardiopulmonary physiology, pharmacotherapeutic considerations, diagnostic and interventional pulmonary procedures during pregnancy, and cardiopulmonary resuscitation in pregnancy.

Keywords

pregnancy - physiology - pharmacotherapy - diagnostic imaging - interventional pulmonary - cardiac arrest - resuscitation