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Restrictive lung disease in pregnancy.

T E King1

  • 1Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Health Sciences Center, Denver.

Clinics in Chest Medicine
|December 11, 1992
PubMed
Summary

Pregnancy with restrictive lung disease is possible but requires careful management. Severe cases (vital capacity < 1 L) may warrant avoiding pregnancy or considering abortion due to risks.

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Area of Science:

  • Pulmonary Medicine
  • Obstetrics
  • Critical Care

Background:

  • Restrictive ventilatory defects limit lung expansion due to lung, pleural, chest wall, or neuromuscular issues.
  • Few studies focus on pregnant women with defined restrictive lung disorders.
  • Most pulmonary diseases manifest post-childbearing years and may not impact fertility.

Purpose of the Study:

  • To review the impact of pregnancy on various restrictive lung disorders.
  • To outline risks and management strategies for pregnant women with these conditions.

Main Methods:

  • Literature review of studies on pregnancy and restrictive lung diseases.
  • Analysis of specific conditions including sarcoidosis, connective tissue diseases, LAM, and kyphoscoliosis.
  • Evaluation of prognostic factors and management recommendations.

Main Results:

  • Pregnancy is a relative contraindication for restrictive lung disease, with potential risks to mother and fetus.
  • Sarcoidosis and connective tissue diseases generally tolerate pregnancy, but PSS with renal involvement poses risks.
  • SLE worsening is uncommon; LAM patients are advised against pregnancy.
  • Kyphoscoliosis can increase premature birth rates and carries risks if unstable.

Conclusions:

  • Pregnant women with severe restrictive lung disease (VC < 1 L) should consider avoiding pregnancy or therapeutic abortion.
  • Optimal medical management and consideration of Cesarean section are crucial for those continuing pregnancy.
  • Prognosis varies by specific condition, with careful monitoring essential.

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