Tashjian AC and Schmiedecke SS
Introduction: The physiologic changes of the respiratory system during pregnancy leave patients increasingly susceptible to viral respiratory disease. There are no documented cases of isolated rhinovirus in pregnancy causing respiratory distress requiring positive pressure ventilation.
Case: A 25-year-old primigravida at 28 weeks gestation reporting upper respiratory symptoms. She became tachycardic, tachypneic and hypoxic despite IV fluids and oxygen by nasal cannula. She was transferred to the ICU and transitioned to positive pressure ventilation via high-flow nasal cannula. Workup was notable only for rhinovirus. She improved following overnight observation in the ICU without need for endotracheal intubation.
Conclusion: We describe the first documented case of rhinovirus causing respiratory distress requiring positive pressure ventilation in a healthy pregnant patient, and the first to demonstrate the safe, effective use of high-flow nasal cannula in the critically-ill pregnant patient.
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