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11/14. subcutaneous emphysema, pneumomediastinum, and pneumothorax in labor and delivery.

    Hamman's syndrome occurs rarely in the setting of labor and delivery. In this report 187 cases of Hamman's syndrome, with and without objective evidence of pneumothorax, are summarized and the literature reviewed. Most of the women were primiparous, and first and second stages of labor were of normal duration (18.3 and 4.1 hour, respectively). Average fetal size (7 pounds, 14 ounces) was also found to be within normal limits. Signs, symptoms, and pathophysiology are reviewed and treatment discussed.
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ranking = 1
keywords = emphysema
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12/14. Spontaneous pneumothorax in pregnancy and labour.

    A case of spontaneous pneumothorax occurring at the end of labour in a healthy 17-year-old primigravida is described. Its occurrence was accompanied by marked surgical emphysema of the face, neck, arms and thorax. The patient had had previous thyroid surgery and was coincidentally found to have bilateral cervical ribs on chest X-ray. Previously described cases are reviewed, and the management discussed. Hypoxia to the fetus is a definite threat, and spontaneous pneumothorax should be considered in the differential diagnosis of chest pain and dyspnoea during delivery. It is a potential extragenital cause of maternal mortality.
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ranking = 0.25
keywords = emphysema
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13/14. Maternal-fetal pneumomediastinum complicating labor: report of a case and review of the literature.

    Maternal pneumomediastinum and subcutaneous emphysema is a rare, alarming but relatively benign complication of labor. It usually manifests itself during the second stage. Once it is diagnosed, further bearing down should be avoided and labor shortened. Due to its rarity, a case is reported with a review of literature. In this case pneumomediastinum and pneumothorax occurred in the newborn, also. To our knowledge, this is the first reported case of simultaneous pneumomediastinum in mother and neonate.
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ranking = 0.25
keywords = emphysema
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14/14. subcutaneous emphysema in labour.

    Spontaneous subcutaneous and mediastinal emphysema is a rare but potentially dangerous complication of labour. The condition was observed in an 18-year-old primigravida in the first stage of labour, who subsequently required Caesarean section which was performed under epidural anaesthesia.
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ranking = 1.25
keywords = emphysema
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