Logo

Log In Sign Up |  An official publication of: American College of Emergency Physicians
Navigation
  • Home
  • Multimedia
    • Podcasts
    • Videos
  • Clinical
    • Airway Managment
    • Case Reports
    • Critical Care
    • Guidelines
    • Imaging & Ultrasound
    • Pain & Palliative Care
    • Pediatrics
    • Resuscitation
    • Trauma & Injury
  • Resource Centers
    • mTBI Resource Center
  • Career
    • Practice Management
      • Benchmarking
      • Reimbursement & Coding
      • Care Team
      • Legal
      • Operations
      • Quality & Safety
    • Awards
    • Certification
    • Compensation
    • Early Career
    • Education
    • Leadership
    • Profiles
    • Retirement
    • Work-Life Balance
  • Columns
    • ACEP4U
    • Airway
    • Benchmarking
    • Brief19
    • By the Numbers
    • Coding Wizard
    • EM Cases
    • End of the Rainbow
    • Equity Equation
    • FACEPs in the Crowd
    • Forensic Facts
    • From the College
    • Images in EM
    • Kids Korner
    • Medicolegal Mind
    • Opinion
      • Break Room
      • New Spin
      • Pro-Con
    • Pearls From EM Literature
    • Policy Rx
    • Practice Changers
    • Problem Solvers
    • Residency Spotlight
    • Resident Voice
    • Skeptics’ Guide to Emergency Medicine
    • Sound Advice
    • Special OPs
    • Toxicology Q&A
    • WorldTravelERs
  • Resources
    • ACEP.org
    • ACEP Knowledge Quiz
    • Issue Archives
    • CME Now
    • Annual Scientific Assembly
      • ACEP14
      • ACEP15
      • ACEP16
      • ACEP17
      • ACEP18
      • ACEP19
    • Annals of Emergency Medicine
    • JACEP Open
    • Emergency Medicine Foundation
  • About
    • Our Mission
    • Medical Editor in Chief
    • Editorial Advisory Board
    • Awards
    • Authors
    • Article Submission
    • Contact Us
    • Advertise
    • Subscribe
    • Privacy Policy
    • Copyright Information

Acute respiratory infection in pregnancy

By Howard Roemer, M.D.; Benjamin Roemer, M.D.; Vern L. Katz, M.D.; Deeksha Dewan, M.D.; and Christopher Bentley, B.S. | on February 1, 2013 | 0 Comment
From the College
  • Tweet
  • Email
Print-Friendly Version

This article is aimed at providing readers with a better understanding of several high risk pulmonary infections in pregnancy. These high-risk conditions are bacterial community-aquired pnewumonia (CAP), influenza, and varicella.

You Might Also Like
  • Wake-up call
  • U.S. Researchers Estimate Microcephaly Risk from Zika Infection
  • Approved Insect Repellants Can be Recommended “Without Reservation” During Pregnancy
Explore This Issue
ACEP News: Vol 32 – No 02 – February 2013

Community Acquired Pneumonia

Incidence: The incidence of CAP [community acquired pneumonia] appears to be comparable to that in non-pregnant patients. However, if acquired, it can result in greater morbidity and mortality because of the physiologic adaptations of pregnancy. It is a leading cause of fatal non-obstetric infection in the pregnant patient. Pneumonia has been reported in 4.2% of antepartum admissions for non-obstetric illnesses.

Maternal Risks: The major factor predisposing pregnant women to severe pneumonic infections is an alteration in immune status. These changes occur primarily in cell-mediated immunity, making viral, fungal, and tuberculous infections particularly pathogenic in these women. As pregnancy progresses, functional residual capacity is decreased by 10% to 25%; which impairs maternal ability to tolerate respiratory disease. A history of asthma, or anemia with hemoglobin less than 10 gm/dl has been shown to increase the incidence of pneumonia significantly. Mortality (compared to that for nonpregnant patients) is higher for viral pneumonia but not as clearly shown for CAP. There may be a higher risk of progression to ARDS and sepsis. However, because of potential higher risk, CAP patients do require aggressive management.

Fetal Disease Course: Pneumonia can cause significant stress to the fetus. Preterm delivery and lower birth weight are risks. Maternal bacteremia can lead to fetal sepsis in some cases.

Clinical Picture: Pneumonia may be misdiagnosed up to 20% of the time due to the many physiologic and anatomic changes of pregnancy. Up to 76% of pregnant patients have underlying subjective dyspnea at 31 weeks. Lung auscultation can be unreliable due to atelectasis of pregnancy. Many patients attribute symptoms of pneumonia to pregnancy.

Diagnostic testing: Diagnostic testing are similar to non-pregnant patients as are listed in the IDSA CAP guidelines. Imaging includes chest X-ray with abdominal shielding as study allows.

Treatment: Prompt diagnosis and treatment with current antimicrobial therapy and intensive care unit management of respiratory compromise has reduced the maternal morbidity and mortality due to pneumonia in pregnancy. Prevention with vaccination in at-risk populations may reduce the prevalence and severity of pneumonia in pregnant women.

Bacterial Pneumonia: Antibiotics are comparable to those used in non-pregnant population as recommended in resources such as Infectious Diseases Society of America/American Thoracic Society Consensus Guidelines on the management of community-acquired pneumonia in adults. This resource recommends fluoroquinolones such as moxifloxacin and gemifloxacin to be used in settings with high beta-lactam and macrolide resistance. The risk of teratogenicity is low, and fluoroquinolones can be given during pregnancy if indicated. Modifications in drug choice may be affected by changing local infection patterns.

Pages: 1 2 3 4 5 6 | Single Page

Topics: Clinical GuidelineEmergency MedicineEmergency PhysicianInfectious DiseaseOB/GYNObstetricsPatient SafetyPregnancyPulmonaryQualityVaccination

Related

  • New Recommendations for Administering RhD IG at Less than 12 Weeks

    May 7, 2025 - 0 Comment
  • How to Diagnose and Manage Hypertensive Disorders in Pregnancy

    March 10, 2025 - 0 Comment
  • EM Runs in the Family

    February 26, 2025 - 0 Comment

Current Issue

ACEP Now May 03

Read More

No Responses to “Acute respiratory infection in pregnancy”

Leave a Reply Cancel Reply

Your email address will not be published. Required fields are marked *


*
*

Wiley
  • Home
  • About Us
  • Contact Us
  • Privacy
  • Terms of Use
  • Advertise
  • Cookie Preferences
Copyright © 2025 by John Wiley & Sons, Inc. All rights reserved, including rights for text and data mining and training of artificial technologies or similar technologies. ISSN 2333-2603