Preterm Labor and Maternal Hypoxia in Patients WithCommunity-Acquired Pneumonia

[摘要] Objective:We sought to determine if preterm labor is associated with the degree of maternal hypoxiain pregnant women with community-acquired pneumonia but no other maternal diseases.Methods:We retrospectively reviewed the medical records of all antepartum patients admittedwith a diagnosis of community-acquired pneumonia to an inner-city university hospital between1983 and 1987. Included in this review were only the patients with radiologically confirmed diagnoseof pneumonia and documented arterial blood gases on room air at the time of admission, but noother maternal diseases.Results:A total of 22 cases were identified. There was no maternal mortality, but there were 2patients (9%) who developed respiratory failure requiring mechanical ventilation. Bacteremia withStreptococcus pneumoniaewas documented in 1 patient (5%). Preterm labor complicated 5 cases(23%) and led to preterm delivery in 3 patients (14%). Terbutaline tocolysis was instituted in 3patients, but was discontinued in 1 patient who was allowed to deliver because of her worseningcondition. Preterm labor was associated with the WBC count on admission, usually > 18,000/mm3,but no statistically significant correlation with the severity of maternal hypoxia was noted. Fivepatients (23%) were incorrectly diagnosed at the time of admission, 4 with an initial diagnosis ofpyelonephritis and 1 with an initial diagnosis of cholecystitis.Conclusions:Community-acquired pneumonia in the antepartum period is responsible for significantmaternal and fetal complications even in the absence of other maternal diseases. Pretermlabor and delivery remain frequent, and tocolysis should be used cautiously. At the time of admission,the diagnosis may be difficult. The degree of maternal hypoxia on admission does not correlatewith the presence of preterm labor.

[学科分类] 妇产科学