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Introduction to respiratory disease

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While respiratory failure is a rare complication of pregnancy, respiratory diseases are one of the more common problems affecting women of reproductive age, especially asthma. Respiratory symptoms, particularly breathlessness, are also common symptoms of pregnancy. Approximately half of all pregnant women will have experienced dyspnoea by 20 weeks of gestation, with three quarters experiencing this by 30 weeks of gestation. However, this will rarely significantly impair on normal activities.

The reason for this subjective feeling of shortness of breath is thought to be mainly due to high progesterone levels acting on the hypothalamus to increase respiratory drive. The enlarging uterus will also have some effect on this feeling. Distinguishing physiological dyspnoea from dyspnoea caused by a disease process is vital.

To understand respiratory diseases in pregnancy, it is essential to understand the physiological changes that pregnancy has on the respiratory system. This allows you to interpret clinical and laboratory manifestations of respiratory diseases.

Learning objectives

Upon completing this tutorial you will be able to:

  • understand the physiological changes that occur in the respiratory system in normal pregnancy
  • understand the impact pregnancy may have on pre-existing respiratory conditions and the impact these diseases may have on pregnancy
  • be able to request and interpret appropriate investigations of respiratory symptoms, as well as liaising with other specialties appropriately
  • manage respiratory diseases during pregnancy

Last updated: 14/04/2011 (Tutorial revised and updated by Miss KP Stanley and Dr Charles Bircher)

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