View source for Lung diseases in pregnancy

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Some '''major changes in respiratory system ''' occur during pregnancy. In the first half of the pregnancy only the minute volume increases, in the second half both the residual volume (RV) and expiratory reserve volume (ERV) are decreased, as well as  pCO<sub>2</sub> in alveoli and arterial blood. Increased values include respiratory volume, minute volume and venous blood oxygen saturation. The values of arterial pO<sub>2</sub> and vital capacity (VC) do not change, they tend to decrease just before giving birth. This article discusses the matter of [[Tuberculosis (pneumology)|tuberculosis]], [[Sarcoidosis (internal medicine)|sarcoidosis]], [[asthma|bronchial asthma]] and [[pneumonia]] in pregnancy.

== Tuberculosis ==
[[File:Tuberculosis-x-ray.jpg|thumb|Tuberculosis-x-ray]]
A gynecologist encounters tuberculosis in women within areas with a high incidence of tuberculosis. In women at risk of contact is  a '''[[Skin tests#Tuberculin test|tuberculin test]]''' indicated, which is also of great importance in pregnancy. When tested positive, an X-ray examination of the chest usually follows with a sample of '''sputum''' (exclusion of acid-resistant rods). If an acute form od tuberculosis is suspected, women undergo antituberculosis therapy in order to prevent congenital tuberculosis and avoid postparttum vertical transmission from the infected mother to the newborn. 
;Therapy
* [[Isoniazid]] and [[rifampicin]] (possibly also etambutol);
* [[vitamine B6|pyridoxin]] is co-administered;
* [[Aminoglycosides#Representatives|streptomycin]] is strictly contraindicated due to possibility of hearing impairment in newborns;
* the newborn has to be vaccinated (BCG vaccine);
* if the mother had not received antiTBC treatment, the newborn should be isolated until negative tuberculine test result
{{Details|Tuberculosis (pneumology)}}

== Sarcoidosis ==
Sarcoidosis is a granulomatous disease that affects lungs, lymph nodes, heart, CNS, skin, eyes and liver. The disease usually '''does not affect''' the pregnancy and is treated with [[glucocorticoids]].

== Bronchial asthma ==
is an issue in about '''1&thinsp;% of all pregnant women''', in about 30&thinsp;% the disease gets better with pregnancy, in 20&thinsp;% worsens and in 50&thinsp;% has no effect on the pregnancy whatsoever. Appropriate treatment and monitoring with continued usage of bronchodilatators or corticosteroids is crucial. It is recommended to increase the dosage of [[glucocorticoids|glucocorticoids]] and to use [[Epidural anesthesia in obstetrics|epidural anesthesia]] during childbirth. 
{{Details|Asthma}}

== Pneumonia ==
[[File:Pneumonia x ray.jpg|thumb|pneumonia X-ray]]
Pneumonia can be caused by '''bacteria''' (mostly likely ''Streptococcus pneumoniae'') or by '''viruses'''. Bacterial pneumonia is treated with [[penicilins|penicilins]] or [[cephalosporins]]. When unsuccessfull, possibility of mycoplasma pneumoniae infection should be considered and treated with [[Macrolides#Representatives|erythromycin]] (for 10–14 days). '''Viral pneumonias''' could induce [[Varicella|varicella]] or [[flu]], with  '''very severe course''' in pregnancy. We use [[Antivirals#Substances against herpes and influenza infections|acyclovir]] for treatment.
{{Details|Pneumonia}}

== Links ==
=== Related articles ===
* [[Lung volumes]]
=== References ===
* {{Cite
| type = book
| isbn = 80-247-1303-9
| surname1 = Čech
| name1 = Evžen
| others = yes
| title = Porodnictví
| edition = 2
| location = Praha
| publisher = Grada
| year = 2006
}}
* Quadruplets of elaborated questions according to study materials from J. Beneše, L. Mikšíka, elearning and book gynekologie a porodnictví / Martius 2005 /.

[[Category:Gynecology]]
[[Category:Obstetrics]]
[[Category:Pneumology]]
[[Category:Internal medicine]]
[[Category:Pathology]]