Pulmonary Problems in Pregnancy Clinical and Research Aspects
Clinically, pregnancy acts as a stress test that unmasks maternal disease and may have long-term implications for maternal and fetal health. In Pulmonary Problems in Pregnancy, the editors provide a state-of-the art, comprehensive text focusing on common
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RESPIRATORY MEDICINE Sharon R. Rounds, MD, SERIES EDITOR Pulmonary Problems in Pregnancy, edited by Ghada Bourjeily and Karen Rosene-Montella, 2009
Pulmonary Problems in Pregnancy
Edited by
Ghada Bourjeily, MD Assistant Professor of Medicine The Warren Alpert Medical School of Brown University Department of Medicine Pulmonary and Critical Care Medicine Women and Infants Hospital of Rhode Island
Karen Rosene-Montella, MD Professor of Medicine and Ob/Gyn The Warren Alpert Medical School of Brown University Chief of Medicine Department of Medicine Women and Infants Hospital of Rhode Island
Editors Ghada Bourjeily Assistant Professor of Medicine The Warren Alpert Medical School of Brown University Department of Medicine Pulmonary and Critical Care Medicine Women and Infants Hospital of Rhode Island Providence, RI [email protected]
Karen Rosene-Montella Professor of Medicine and Ob/Gyn The Warren Alpert Medical School of Brown University Chief of Medicine Department of Medicine Women and Infants Hospital of Rhode Island Providence, RI [email protected]
ISBN 978-1-934115-12-1 e-ISBN 978-1-59745-445-2 DOI 10.1007/978-1-59745-445-2 Library of Congress Control Number: 2008938362 # Humana Press, a part of Springer ScienceþBusiness Media, LLC 2009 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Humana Press, c/o Springer ScienceþBusiness Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Cover Illustration: Figure 1, Chapter 22 Printed on acid-free paper springer.com
Preface
Pregnancy is associated with physiologic changes that help compensate for the increasing demands of the fetus and placenta. Clinically, pregnancy acts as a stress test that unmasks maternal disease and may have long term implications for maternal and fetal health. General obstetricians are often hesitant to care for complex medical problems, and internists to care for pregnant patients, which may create a gap into which sick pregnant women will fall at a time when they are most vulnerable. Investigation and treatment of pregnant patients with pulmonary disorders is often hindered by both a
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