| Case Study 5: breathlessness in pregnant lady -
07-07-2006, 08:22 PM
A 26-year-old woman is being evaluated for symptoms of a cough, breathlessness, and chest tightness that began 4 weeks ago. She is 18 weeks' gestation of her first pregnancy. The patient reports a history of respiratory difficulties in childhood that improved during adolescence. Physical examination reveals mild congestion of the nasal mucosa, normal breath sounds, no wheezes or crackles, normal heart sounds, and no murmur. Spirometry shows her forced expiratory volume in 1 second (FEV1) to be 2.4 L/s and her forced expiratory capacity (FVC) to be 3.6 L. After 2 puffs of albuterol, FEV1 and FVC increase to 2.8 L/s and 3.8 L, respectively.
What is the diagnosis? Which medication will give her the best likelihood for a good perinatal outcome?
Hint:Approximately 30% of women with this pregnancy-related condition improve during term. |