A 29-year-old woman with a 15-year history of asthma was hospitalized on the obstetrical service at about 37 weeks’ gestation. During this pregnancy alone she had been admitted four times for asthma attacks; the last was a bout of status asthmaticus, less than 2 weeks previously, requiring intubation and mechanical ventilation for several days. She had subsequently been managed on theophylline 300mg po b.i.d., metaproterenol by nebulizer q4h, and prednisone 20mg daily. On physical examination she was afebrile; respiratory rate, 18/min; pulse, 100/min; blood pressure, 110l70mmHg in the lateral recumbent position. Mild diffuse expiratory wheezes were heard. Peak flow was 180L/min. Hemogram showed a leukocyte count of 10.3 without shift; hematocrit 29%; arterial blood gas on room air was reported as 7.42/30/98, and the serum theophylline level was 8.9μg/ml. The patient was proposed for cesarean section because of breech presentation.
KeywordsTotal Lung Capacity Beta Agonist Status Asthmaticus Airway Narrowing Clin Chest
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