A 19-year-old primigravida had a normal vaginal delivery after a 90-minute second stage of labour. Within two hours she complained of dyspnoea and was noticed to have unusual swelling of the face and neck. The diagnosis of subcutaneous emphysema was confirmed by chest X-ray and pneumomediastinum was also detected. Uneventful recovery over four days followed conservative management, administration of oxygen and use of simple analgesics.
MogilL.G., FriedmanA.H.Ocular complications. In: CohenWR ed. Cherry and Meskatz's Complications of Pregnancy,5th Ed.Lippincott, Williams and Wilkins, Philadelphia2000; 555–571.
2.
CartlidgeN.E.F.Neurologic disorders. In: BarronW.M., LindheimerMD eds. Medical Disorders During Pregnancy,2nd Ed.Mosby, St. Louis1995; 430–450.
3.
TeirsteinA.S., SchileroG.J., LesserM.Respiratory disease. In: CohenWR ed. Cherry and Meskatz's Complications of Pregnancy,5th Ed.Lippincott, Williams and Wilkins, Philadelphia2000; 233–265.
4.
HammanL.Mediastinal emphysema.JAMA1945; 128: 1–6.
5.
Jayran-NejadY.Subcutaneous emphysema in labour.Anaesthesia1993; 48: 139–140.
6.
ArroyoM.Subcutaneous emphysema during labour.Int J Obstet Anesth2001; 10: 307–308.
7.
WeinbergerS.E., WeissS.T.Pulmonary diseases. In: BurrowG.N., DuffyTP eds. Medical Complications During Pregnancy,5th Ed.WB Saunders, Philadelphia1999; 363–400.
8.
De SwietM.Diseases of the respiratory system. In: de SwietM ed. Medical Disorders in Obstetric Practice,3rd Ed.Blackwell Science, Oxford1995; 1–32.
9.
SchwartzM., RossoffL.Pneumomediastinum and bilateral pneumothoraces in a patient with hyperemesis gravidarum.Chest1994; 106: 1904–1906.
10.
BenseL., EklundG., OdontD., WimanL-G. Smoking and the increased risk of contracting spontaneous pneumothorax.Chest1987; 92: 1009–1012.
HazouardE., KoninckJ-C, AttucciS., Fauchier-RollandF., BrunereauL., DiotP.Pneumorachis and pneumomediastinum caused by repeated Muller's maneuvers: Complications of marijuana smoking.Ann Emerg Med2001; 38: 694–697.
13.
MazurS., HitchcockT.Spontaneous pneumomediastinum and ecstasy abuse.Emerg Med2001; 13: 121–123.
14.
UvaJ.L.Spontaneous pneumothoraces, pneumomediastinum and pneumoperitoneum: Consequences of smoking crack cocaine.Ped Emerg Care1997; 13: 24–26.
15.
ReederS.R.Subcutaneous emphysema, pneumomediastinum and pneumothorax in labor and delivery.Am J Obstet Gynecol1986; 154: 487–489.
16.
SymbasP.N.Emergency department patient management of chest trauma. In: SchwartzG.R. ed. Principles and Practice of Emergency Medicine,4th Ed.Williams and Wilkins, Baltimore1999; 307–317.
17.
CapanL.M., MillerS.M.Trauma and burns. In: BarashP.G., CullenB.F., StoeltingR.K. eds. Clinical Anesthesia,4th Ed.Lippincott, Williams and Wilkins, Philadelphia2001; 1255–1296.
18.
KarsonE.M., SaltzmanD., DavisM.R.Pneumomediastinum in pregnancy: two case reports and a review of the literature, pathophysiology and management.Obstet Gynecol1984; 64: 39S.
19.
GrayJ.M., HansonG.C.Mediastinal emphysema: aetiology, diagnosis and treatment.Thorax1966; 21: 325–332.