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Emerg Med J 24:861-862 doi:10.1136/emj.2007.048967
  • Emergency casebooks

Unsuspected 34-week pregnancy presenting as acute hypoxaemic respiratory failure

  1. Andrew M Luks
  1. Pulmonary and Critical Care Medicine, University of Washington, Seattle, Washington, USA
  1. Andrew M Luks, MD, Pulmonary and Critical Care Medicine, University of Washington, 1959 NE Pacific Street, Box 356522, Seattle, WA 98195-6522, USA; aluks{at}u.washington.edu
  • Accepted 6 April 2007

Abstract

An obese body habitus may interfere with diagnosis of potentially life-threatening conditions. This report describes an obese woman who presented with acute hypoxemic respiratory failure and diffuse infiltrates. Her body habitus disguised her parturient abdomen and she could not provide a history because she was intubated and paralysed. Only after a urine pregnancy test was undertaken did it become apparent that she was pregnant and the diagnosis of pre-eclampsia with pulmonary oedema was considered. Urine pregnancy tests are part of the standard work-up for abdominal pain in women of childbearing age, but are not viewed as part of the work-up for respiratory distress or diffuse radiographic infiltrates. This case illustrates the value of obtaining a pregnancy test in all women, particularly those with obese body habitus, who present with respiratory failure of unclear aetiology.

Footnotes

  • Competing interests: The author has no personal of financial support or involvement with organisations with financial interest in the subject matter and has no conflicts of interest.

  • Consent: The patient has provided verbal consent for this report.