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Vol. 13. Issue 2.
Pages 213-237 (March - April 2007)
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Vol. 13. Issue 2.
Pages 213-237 (March - April 2007)
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Pulmão e gravidez
Pregnancy and lungs
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927
Inês A C Gonçalves Marcos1, João Valença Rodrigues2, Renato Sotto-Mayor3
1 Interna do 5.° ano de Pneumologia, Serviço de Pneumologia, Hospital de Santa Maria, Lisboa
2 Assistente Graduado de Pneumologia, Serviço de Pneumologia, Hospital de Santa Maria, Lisboa
3 Director do Serviço de Pneumologia, Serviço de Pneumologia, Hospital de Santa Maria, Lisboa
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Resumo

A patologia respiratória é relativamente frequente durante a gravidez. Um terço das grávidas sofrem exacerbação da asma. O tromboembolismo pulmonar é cerca de 5 vezes mais frequente na gravidez. As pneumonias bacterianas, virais e fúngicas são mal toleradas pela grávida, provocando significativa morbilidade materno-fetal, insuficiência respiratória, baixo peso ao nascer ou prematuridade. A tuberculose, se não for tratada, pode aumentar em 4 vezes a mortalidade materna e em 9 vezes o parto pré-termo. A gravidez está contra-indicada em mulheres com fibrose quística e função pulmonar grave. Apesar dos progressos terapêuticos, a hipertensão pulmonar continua a estar associada a valores superiores a 30% de morbilidade e mortalidade materno-fetal. Aproximadamente 1 em 1000–1500 gravidezes é complicada por neoplasia maligna materna. O cancro do pulmão nas grávidas coloca desafios terapêuticos importantes devido às elevadas taxas de mortalidade.

Palavras-chave:
Pulmão
gravidez
alterações fisiológicas
complicações pulmonares
Abstract

Respiratory pathology can be relatively frequent during pregnancy. One third of pregnant woman may experience worsening of their asthma condition. Pulmonary tromboembolism is 5 times more frequent in pregnancy. Bacterial, viral and fungal pneumonias are baddly tolerated during pregnancy, provoking mother-foetal morbidity, respiratory insufficiency, low born-weight or prematurity. Non-treated tuberculosis may increase maternal mortality and preterm birth by 4 and 9 times respectively. Pregnancy is counter-indicated in women with cystic fibrosis and severe pulmonary function. Despite therapeutic progresses already made, pulmonary hypertension is associated to over 30% of mother-foetal morbidity and mortality. Approximately 1 in 1,000-1,500 pregnancies is affected by mother cancer. High rates of lung cancer morbility in women bring new and important challenges to therapy.

Key-words:
Pregnancy
lung
physiological changes
pulmonary complications
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