Management and outcome of pregnant women with interstitial and restrictive lung disease

OBJECTIVE: Our purpose was to describe our experience with management and outcome of restrictive lung disease in pregnancy. STUDY DESIGN: Between 1981 and 1994 nine pregnant women with interstitial and restrictive lung disease were prospectively managed and delivered at the University of Washington Medical Center. RESULTS: Three patients had severe disease, characterized by vital capacity ≤1.5 L (50% predicted) or diffusing capacity <-50% predicted. Five patients had exercise-induced oxygen desaturation, and four required supplemental oxygen. Five patients required corticosteroids. One patient had an adverse outcome; she was delivered at 31 weeks and required mechanical ventilation for 72 hours. All other patients were delivered at or beyond 36 weeks with no adverse intrapartum or postpartum complications. All babies were at or above the 30th percentile for growth. CONCLUSIONS: Restrictive lung disease is tolerated in pregnancy. Exercise intolerance is common and patients may require early oxygen supplementation. Adequate fetal growth can be achieved.