Mehta Niharika, Chen Kenneth, Hardy Erica, Powrie Raumond
Warren Alpert Medical School of Brown University, Providence, RI, USA.
Warren Alpert Medical School of Brown University, Providence, RI, USA.
Best Pract Res Clin Obstet Gynaecol. 2015 Jul;29(5):598-611. doi: 10.1016/j.bpobgyn.2015.04.005. Epub 2015 Apr 20.
Many physiological and anatomical changes of pregnancy affect the respiratory system. These changes often affect the presentation and management of the various respiratory illnesses in pregnancy. This article focuses on several important respiratory issues in pregnancy. The management of asthma, one of the most common chronic illnesses in pregnancy, remains largely unchanged compared to the nonpregnant state. Infectious respiratory illness, including pneumonia and tuberculosis, are similarly managed in pregnancy with antibiotics, although special attention may be needed for antibiotic choices with more pregnancy safety data. When mechanical ventilation is necessary, consideration should be given to the maternal hemodynamics of pregnancy and fetal oxygenation. Maintaining maternal oxygen saturation above 95% is recommended to sustain optimal fetal oxygenation. Cigarette smoking has known risks in pregnancy, and current practice guidelines recommend offering cognitive and pharmacologic interventions to pregnant women to assist in smoking cessation.
孕期的许多生理和解剖学变化会影响呼吸系统。这些变化常常影响孕期各种呼吸道疾病的表现及管理。本文重点关注孕期几个重要的呼吸问题。哮喘是孕期最常见的慢性疾病之一，与非孕期相比，其管理方法基本不变。包括肺炎和肺结核在内的感染性呼吸道疾病，在孕期同样使用抗生素进行治疗，不过在选择抗生素时可能需要特别关注更多的孕期安全性数据。当需要机械通气时，应考虑孕期的母体血流动力学和胎儿氧合情况。建议将母体氧饱和度维持在95%以上，以维持最佳的胎儿氧合。吸烟在孕期存在已知风险，当前的实践指南建议为孕妇提供认知和药物干预措施，以帮助其戒烟。
