Foreign body aspiration in pregnancy

Area of Science:

• Pulmonology
• Critical Care Medicine
• Obstetrics

Background:

• A 24-year-old morbidly obese African American woman (gravida 1) with a history of severe asthma presented at 30 weeks gestation.
• She had multiple prior inpatient admissions for asthma exacerbations.

Purpose of the Study:

• To report a rare case of foreign body aspiration in the left main stem bronchus during pregnancy.
• To highlight the management challenges and complications in this unique clinical scenario.

Main Methods:

• The patient presented with a foreign body in the left main stem bronchus.
• Initial management included bronchoscopy, which was unsuccessful in foreign body retrieval postpartum.
• Subsequent attempts at bronchoscopic retrieval were complicated by respiratory failure, intubation, ICU admission, and development of postobstructive pneumonia.

Main Results:

• The patient required mechanical ventilation for two weeks in the intensive care unit.
• Multiple bronchoscopic attempts to remove the foreign body failed.
• The patient developed postobstructive pneumonia, necessitating a left lower lung lobectomy for definitive treatment.

Conclusions:

• Foreign body aspiration in the tracheobronchial tree during pregnancy poses significant diagnostic and therapeutic challenges.
• Management requires a multidisciplinary approach, and complications such as respiratory failure and pneumonia can necessitate aggressive surgical intervention like lobectomy.