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Hemoptysis during pregnancy: a comprehensive review of literature and an unprecedented case report of oropharyngeal carcinoma
Affiliations- Department of Obstetrics, Gynecology, Gynecological Oncology and Gynecological Endocrinology, University Clinical Center, Gdansk, Poland, Poland
- Department of Otolaryngology, University Clinical Center, Gdansk, Poland
- Bocian Fertility Clinic, Gynecology and Obstetrics, Gdansk, Poland
- Department of Otolaryngology, Medical University of Gdansk, Gdansk, Poland, Poland
- Division of Gynecology and Obstetrics, Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdansk, Poland
open access
Abstract
Objectives: Hemoptysis in pregnancy is a very rare finding causing diagnostic and therapeutic difficulties. The case report of hemoptysis by a 29 years old patient in the 31st week of pregnancy is presented and discussed along with the diagnostic process and treatment provided. Upon pharyngeal cancer occurrence in a pregnant patient a multidisciplinary medical team performed appropriate treatment along with delivery of a healthy newborn at term. Patients and fetal conditions and outcomes were analyzed and compared to available literature in this newly created literature review. Material and methods: After MEDLINE database analysis using formula "hemoptysis" AND "pregnancy" more than 125 results were found published during the period 2002–2022. Almost 30 papers about hemoptysis were found and included for full analysis. Conclusions: The literature review offers a detailed description of previously reported incidents of hemoptysis in pregnancy to gain understanding of the etiology, differential diagnosis, available treatment and predicted future outcomes for both patient and fetus.
Abstract
Objectives: Hemoptysis in pregnancy is a very rare finding causing diagnostic and therapeutic difficulties. The case report of hemoptysis by a 29 years old patient in the 31st week of pregnancy is presented and discussed along with the diagnostic process and treatment provided. Upon pharyngeal cancer occurrence in a pregnant patient a multidisciplinary medical team performed appropriate treatment along with delivery of a healthy newborn at term. Patients and fetal conditions and outcomes were analyzed and compared to available literature in this newly created literature review. Material and methods: After MEDLINE database analysis using formula "hemoptysis" AND "pregnancy" more than 125 results were found published during the period 2002–2022. Almost 30 papers about hemoptysis were found and included for full analysis. Conclusions: The literature review offers a detailed description of previously reported incidents of hemoptysis in pregnancy to gain understanding of the etiology, differential diagnosis, available treatment and predicted future outcomes for both patient and fetus.
Keywords
hemoptysis; pseudohemoptysis; pregnancy; oropharyngeal carcinoma; minor salivary gland carcinoma
About this articleTitle
Hemoptysis during pregnancy: a comprehensive review of literature and an unprecedented case report of oropharyngeal carcinoma
Journal
Issue
Article type
Research paper
Pages
491-499
Published online
2022-09-27
Page views
1550
Article views/downloads
1028
DOI
Pubmed
Bibliographic record
Ginekol Pol 2023;94(6):491-499.
Keywords
hemoptysis
pseudohemoptysis
pregnancy
oropharyngeal carcinoma
minor salivary gland carcinoma
Authors
Natalia Mazur
Jakub Osowski
Ewa Gostkowska
Dominik Stodulski
Boguslaw Mikaszewski
Dariusz Wydra
References (56)- Kline J, Kabrhel C. Emergency Evaluation for Pulmonary Embolism, Part 1: Clinical Factors that Increase Risk. The Journal of Emergency Medicine. 2015; 48(6): 771–780.
- Chan WS. Can pregnancy-adapted algorithms avoid diagnostic imaging for pulmonary embolism? Hematology Am Soc Hematol Educ Program. 2020; 2020(1): 184–189.
- Dado CD, Levinson AT, Bourjeily G. Pregnancy and Pulmonary Embolism. Clin Chest Med. 2018; 39(3): 525–537.
- Blondon M, Martinez de Tejada B, Glauser F, et al. Management of high-risk pulmonary embolism in pregnancy. Thromb Res. 2021; 204: 57–65.
- Cohen SL, Feizullayeva C, McCandlish JA, et al. Comparison of International Societal Guidelines for the Diagnosis of Suspected Pulmonary Embolism during Pregnancy. Lancet Haematol. 2020; 7: 247–258.
- Hobohm L, Farmakis IT, Münzel T, et al. Pulmonary Embolism and Pregnancy-Challenges in Diagnostic and Therapeutic Decisions in High-Risk Patients. Front Cardiovasc Med. 2022; 9: 856594.
- Lockwood CJ. Pregnancy-associated changes in the hemostatic system. Clin Obstet Gynecol. 2006; 49(4): 836–843.
- Katz D, Beilin Y. Disorders of coagulation in pregnancy. British Journal of Anaesthesia. 2015; 115: ii75–ii88.
- Subtil SF, Mendes JM, Areia AL, et al. Update on Thrombocytopenia in Pregnancy. Rev Bras Ginecol Obstet. 2020; 42(12): 834–840.
- Cines DB, Levine LD. Thrombocytopenia in pregnancy. Blood. 2017; 130(21): 2271–2277.
- Fogerty AE. Thrombocytopenia in Pregnancy: Mechanisms and Management. Transfus Med Rev. 2018; 32(4): 225–229.
- Hujoel P, Lingström P. Nutrition, dental caries and periodontal disease: a narrative review. Journal of Clinical Periodontology. 2017; 44: S79–S84.
- Stephens MB, Wiedemer JP, Kushner GM. Dental Problems in Primary Care. Am Fam Physician. 2018; 98(11): 654–660.
- Vaiman M, Klin B, Rosenfeld N, et al. Pediatric Pulmonary Hemorrhage vs. Extrapulmonary Bleeding in the Differential Diagnosis of Hemoptysis. Cent Asian J Glob Health. 2017; 6(1): 284.
- Earwood JS, Thompson TD. Hemoptysis: evaluation and management. Am Fam Physician. 2015; 91(4): 243–249.
- de Haan J, Vandecaveye V, Han SN, et al. Difficulties with diagnosis of malignancies in pregnancy. Best Pract Res Clin Obstet Gynaecol. 2016; 33: 19–32.
- Hepner A, Negrini D, Hase EA, et al. Cancer During Pregnancy: The Oncologist Overview. World J Oncol. 2019; 10(1): 28–34.
- Wolters V, Heimovaara J, Maggen C, et al. Management of pregnancy in women with cancer. International Journal of Gynecologic Cancer. 2021; 31(3): 314–322.
- McCormick A, Peterson E. Cancer in Pregnancy. Obstet Gynecol Clin North Am. 2018; 45(2): 187–200.
- Cubillo A, Morales S, Goñi E, et al. Multidisciplinary consensus on cancer management during pregnancy. Clin Transl Oncol. 2021; 23(6): 1054–1066.
- Arabi A, Ayoola-Adeola M, Nguyen HQ, et al. Pulmonary metastasis as a primary manifestation of gestational choriocarcinoma in a third trimester pregnancy. Gynecol Oncol Rep. 2021; 36: 100762.
- Moreno-Gomez B, Castillo-Aznar J, Tejedor-Vargas P, et al. Coriocarcinoma de placenta metastásico en embarazo de 34 semanas. Revisión y manejo. Cirugía y Cirujanos. 2021; 89(4).
- Zhang W, Liu B, Wu J, et al. Hemoptysis as primary manifestation in three women with choriocarcinoma with pulmonary metastasis: a case series. J Med Case Rep. 2017; 11(1): 110.
- Pervaiz A, Inany M, Nguyen H, et al. A Pregnant Woman With Hemoptysis and Diffuse Pulmonary Nodules. Chest. 2021; 160(6): e651–e656.
- Álvarez-Sarrado L, González-Ballano I, Herrero-Serrano R, et al. Hemoptysis as the first symptom in the diagnosis of metastatic choriocarcinoma in the third trimester of pregnancy: A case report. Case Reports in Women's Health. 2020; 27: e00211.
- Jafarzadeh H, Sanatkhani M, Mohtasham N. Oral pyogenic granuloma: a review. J Oral Sci. 2006; 48(4): 167–175.
- Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3): 209–249.
- Seethala RR, Chiosea SI. MAML2 Status in Mucoepidermoid Carcinoma Can No Longer Be Considered a Prognostic Marker. Am J Surg Pathol. 2016; 40(8): 1151–1153.
- Chiosea SI, Dacic S, Nikiforova MN, et al. Prospective testing of mucoepidermoid carcinoma for the MAML2 translocation: clinical implications. Laryngoscope. 2012; 122(8): 1690–1694.
- Bishop JA, Cowan ML, Shum CH, et al. MAML2 Rearrangements in Variant Forms of Mucoepidermoid Carcinoma: Ancillary Diagnostic Testing for the Ciliated and Warthin-like Variants. Am J Surg Pathol. 2018; 42(1): 130–136.
- O'Gurek D, Choi HY. Hemoptysis: Evaluation and Management. Am Fam Physician. 2022; 105(2): 144–151.
- Ittrich H, Bockhorn M, Klose H, et al. The Diagnosis and Treatment of Hemoptysis. Deutsches Ärzteblatt international. 2017.
- Binesh F, Samet M, Bovanlu TR. A case of pulmonary carcinoid tumour in a pregnant woman successfully treated with bronchoscopic (electrocautery) therapy. BMJ Case Rep. 2013; 2013.
- Porres-Aguilar M, Figueroa-Casas J, Porres-Muñoz M, et al. A 38-Year-Old Pregnant Woman with Hemoptysis and Acute Renal Failure. Respiration. 2011; 82(1): 60–64.
- Blitz MJ, Fleischer A. Severe Maternal Morbidity Associated with Systemic Lupus Erythematosus Flare in the Second Trimester of Pregnancy. Case Rep Obstet Gynecol. 2018; 2018: 5803479.
- Blyth DF, Soni MA, Moran NF. Massive hemoptysis in an immunocompromised pregnant woman with human immunodeficiency virus disease and active pulmonary tuberculosis. Ann Thorac Surg. 2007; 84(6): 2085–2086.
- Maturu VN, Bal A, Singh N. Inflammatory myofibroblastic tumor of the lung in pregnancy mimicking carcinoid tumor. Lung India. 2016; 33(1): 82–84.
- El Hammoumi M, Benosman A, Kabiri ElH. Giant teratoma presenting with pregnancy and causing respiratory failure. Arch Bronconeumol. 2015; 51(5): 250–251.
- Hanick AL, Meleca JB, Billings SD, et al. Pyogenic granuloma of the larynx: A rare cause of hemoptysis. Am J Otolaryngol. 2019; 40(2): 331–333.
- Holzmann K, Kropfmüller R, Schinko H, et al. Lung cancer in pregnancy. Wien Klin Wochenschr. 2015; 127(15-16): 639–644.
- Dhillon SS, Yendamuri S, Harris K, et al. Lymphangioma presenting as hemoptysis in pregnancy. Am J Respir Crit Care Med. 2014; 190(6): 701–703.
- Hashemi F, Rezaitalab F, Jalalyazdi M. Massive hemoptysis in a pregnant woman: the first rare presentation of mitral valve stenosis. Monaldi Archives for Chest Disease. 2020; 90(2).
- Flight WG, Tang I, Gates A, et al. Massive haemoptysis and ventilatory failure in pregnancy. Thorax. 2019; 74(8): 818–820.
- Chen T, Yao Li, Zhu C. Venovenous Extracorporeal Membrane Oxygenation Combined with Fiberoptic Bronchoscopy-Assisted CO Cryotherapy in the Treatment of Massive Hemoptysis in Pregnancy: A Case Report. Int J Gen Med. 2020; 13: 1291–1296.
- Shaikh S, Saad RA, Christie G, et al. Spontaneous dissection of an anomalous systemic artery in the lung during pregnancy: a rare cause of hemoptysis. Ann Thorac Surg. 2006; 82(2): 725–726.
- Choi Y, Kang N, Im Y, et al. Unilateral pulmonary artery agenesis manifested by hemoptysis in pregnancy. Respir Med Case Rep. 2019; 26: 14–16.
- Qin J, Song G, Liu Q. Goodpasture's syndrome in early pregnancy: A case report. Exp Ther Med. 2018; 15(1): 407–411.
- Masukume G, Sengurayi E, Moyo P, et al. Massive hemoptysis and complete unilateral lung collapse in pregnancy due to pulmonary tuberculosis with good maternal and fetal outcome: a case report. BMC Res Notes. 2013; 6: 335.
- Forster F, Schulte W. [Hemoptysis in Pregnancy]. Pneumologie. 2019; 73(4): 244–248.
- Kikon M, Choudhury K, Prakash N, et al. Mitral valve replacement in a young pregnant woman: A case report and review of literature. Research in Cardiovascular Medicine. 2014; 3(2): 3.
- Kudo S, Yanagi F, Kozuma S, et al. [Tuberculosis detected after emergency cesarean section]. Masui. 2002; 51(8): 924–926.
- Peyrat E, Chabbert V, Escamilla R, et al. Idiopathic hemoptysis in pregnant women: a distinct entity? Respir Med. 2007; 101(10): 2221–2223.
- Sanchis MC, Vela RA, Gosálbez DJ. Cesarean Section in a Patient with Threatening Hemoptysis Caused by Tracheal Carcinoid. Rev Esp Anestesiol Reanim. 2002; 49: 550–554.
- Li X, Li J, Rao X, et al. A case report of tracheal inflammatory myofibroblastic tumor in a 34-week pregnant woman misdiagnosed with asthma. Medicine (Baltimore). 2017; 96(33): e7872.
- Yang X, Ma W, Shi X, et al. Novel approach of rigid bronchoscopy concurrent with cesarean section and bronchial arterial embolism for patients with massive hemoptysis during pregnancy: case reports and literature review. Ann Transl Med. 2021; 9(7): 582.
- Kang AhY, Baek YH, Sohn YJ, et al. Diffuse alveolar hemorrhage associated with antineutrophil cytoplasmic antibody levels in a pregnant woman taking propylthiouracil. Korean J Intern Med. 2006; 21(4): 240–243.
