| Abstract [eng] |
Primary spontaneous pneumothorax during pregnancy depicts a rare clinical entity among a generally broad spectrum of pneumological diseases. Occurring in absence of concomitant diseases primary spontaneous pneumothorax is most commonly provoked by apically presenting bullae and blebs. Consequent air accumulation within the pleural space leads to lung collapse and the development of primarily chest pain and dyspnea, the most common clinical signs presenting in pregnant patients. These symptoms as well as diagnostic approaches are similar in non-pregnant patients, including imaging techniques such as chest radiography, ultrasound and CT scan. In contrast to non-pregnant patients, fetal exposure to radiation marks a crucial role during pregnancy and should always be minimized. Still, combined with sufficient abdominal shielding, it is mostly considered safe, as research indicates. Treatment approaches of primary spontaneous pneumothorax during pregnancy depend on various factors including size of pneumothorax, severity of clinical signs and the general health condition of pregnant women. Reported cases about simultaneous presentation of pregnancy and primary spontaneous pneumothorax indicate the clinical relevance and offer various treatment approaches among different gestational ages individualized for each patient. Reaching from conservative approaches including supplemental oxygen and chest tube placement to more invasive measures up to Video-assisted Thoracic Surgery procedures. Depending on recurrent presentation as well as persistency of disease, surgical interventions are considered to be the safest during second trimester but should be evaluated among interdisciplinary doctors and specialists. Overall, possible maternal and fetal compromise plays a crucial role in prompt recognition and management steps of primary spontaneous pneumothorax. The clinical picture therefore faces various obstetric, gynecological as well as thoracic surgical challenges. Concludingly, primary spontaneous pneumothorax marks a relevant clinical emergency requiring rapid recognition and orderly multidisciplinary handling. Even though recent scientific data is still insufficient in order to either correlate or disconnect pregnancy with primary spontaneous pneumothorax exact pathophysiological development, physiological changes during pregnancy might possibly contribute to development of pulmonological conditions. Influence through hormones during pregnancy, as well as pressure and structural changes including tissue integrity are relevant adaptations being discussed and interrelated during the thesis. The master thesis outlines the relevance of the condition solely, describes physiological changes occurring in pregnant women and interconnects published cases of primary spontaneous pneumothorax in pregnancy with the ongoing question about a correlation among both: pregnancy and primary spontaneous pneumothorax. The literature search for the master thesis included medical databases such as PubMed, Science Direct combined with medical textbooks and case reports regarding primary spontaneous pneumothorax and pregnancy. |
