• Fabrizio Racca, Yaroslava Longhitano, Christian Zanza, Mario Giosuè Balzanelli, Gaetano Draisci, Paolo Augusto Stoia, Evelina Gollo, Mariella Maio, Claudia Grattarola, Marinella Astuto, Antonello Ciccarelli, Giulia Racca, Tatsiana Romenskaya, Benedetta Giordano, Alessandra Serraino, Valeria Ada Maria Sansone, Cesare Gregoretti, Giorgio Conti, Fabio Piccolella, and Rosanna Vaschetto.
• Department of Anesthesiology and Intensive Care, Azienda Ospedaliera SS. Antonio E Biagio E Cesare Arrigo, Alessandria, Italy.
• BMC Anesthesiol. 2023 Oct 13; 23 (1): 342342.

BackgroundPregnant women with neuromuscular diseases (NMDs) often display respiratory muscle impairment which increases the risk for pulmonary complications (PCs). The aim of this study was to identify pregnant NMDs patients with pulmonary risk factors and to apply in these women non-invasive ventilation (NIV) combined with mechanical insufflation-exsufflation (MI-E) in the peri-partum period.MethodsWe conducted a multicenter observational study on women with NMDs undergoing cesarean section or spontaneous labor in a network of 7 national hospitals. In these subjects we applied a protocol for screening and preventing PCs, and we evaluated PCs rate, maternal and neonatal outcome.ResultsTwenty-four patients out of the 94 enrolled pregnant women were at risk for PCs and were trained or retrained to use NIV and/or MI-E before delivery. After delivery, 17 patients required NIV with or without MI-E. Despite nine out of the 24 women at pulmonary risk developed postpartum PCs, none of them needed reintubation nor tracheostomy. In addition, the average birth weight and Apgar score were normal. Only one patient without pulmonary risk factors developed postpartum PCs.ConclusionThis study showed the feasibility of applying a protocol for screening and treating pregnant NMDs women with pulmonary risk. Despite a PCs rate of 37% was observed in these patients, maternal and neonatal outcome were favorable.© 2023. BioMed Central Ltd., part of Springer Nature.

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