Question

Enumerate the causes of dyspnoea during pregnancy.

Hint:

Dyspnoea during pregnancy can be caused by normal physiological changes, but underlying conditions such as anemia, asthma, or heart disease should be ruled out in cases of severe or persistent symptoms.

Answer 1

Step 1: Causes of Dyspnoea During Pregnancy.
Dyspnoea (shortness of breath) during pregnancy is common, particularly in the later stages, and can result from physiological changes or underlying medical conditions. The main causes of dyspnoea during pregnancy include:
(1) Physiological Changes of Pregnancy:
- Increased Oxygen Demand: The body requires more oxygen during pregnancy, and the growing uterus pushes upward on the diaphragm, reducing lung capacity and causing mild dyspnoea, especially in the third trimester.
- Increased Blood Volume and Cardiac Output: Pregnancy results in increased blood volume and cardiac output, which places additional strain on the heart and lungs. This can lead to mild shortness of breath, particularly during exertion.
(2) Anemia:
- Anemia, particularly iron-deficiency anemia, is common during pregnancy and can cause fatigue and dyspnoea on exertion, as the oxygen-carrying capacity of the blood is reduced.
(3) Obesity:
- Overweight or obesity during pregnancy increases the workload of the heart and lungs, often resulting in dyspnoea at rest or with minimal activity.
(4) Respiratory Conditions:
- Asthma and chronic obstructive pulmonary disease (COP can worsen during pregnancy and cause dyspnoea due to airflow limitation.
- Pulmonary embolism or deep vein thrombosis (DVT) can also cause sudden and severe dyspnoea during pregnancy, often accompanied by chest pain or hemoptysis.
(5) Cardiovascular Conditions:
- Heart disease or pregnancy-induced hypertension (pre-eclampsi can result in dyspnoea due to reduced cardiac output, pulmonary edema, or heart failure.
- Peripartum cardiomyopathy is a rare cause of dyspnoea, typically in the last month of pregnancy or within a few months after delivery.
(6) Pulmonary Edema:
- Pulmonary edema can develop due to heart failure, pre-eclampsia, or infection, leading to difficulty breathing, especially when lying flat (orthopne.
(7) Gastroesophageal Reflux Disease (GER:
- GERD is common during pregnancy and can cause dyspnoea due to aspiration of gastric contents or diaphragmatic irritation.