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Dyspnoea of pregnancy

Many women with an otherwise normal pregnancy may complain of shortness of breath. Dyspnoea may develop in the first or second trimester, and by the third trimester 70% of women complain of some difficulty in breathing (6).

The mechanism is not entirely clear and does not seem to correlate purely with uterine size. It appears to be more related to the physiological increase in minute ventila­tion. This hyperventilation produces an increased respiratory effort and increased motor cortical stimulation of the respiratory centre. The dyspnoea reflects a normal awareness of increased ventilation in some women (7).

The diagnosis of this benign dyspnoea of pregnancy is made in the presence of isolated dyspnoea not usually affecting daily activ­ities, with physiological measurements within the accepted range for pregnancy, the absence of associated symptoms, and the exclusion of other pathologies. Sudden, episodic dyspnoea is more likely to be as­sociated with a pathological condition. Increased exercise-induced dyspnoea may also occur in pregnancy.

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Source: Arulkumaran S., Ledger W., Denny L., Doumouchtsis S. (eds.). Oxford Textbook of Obstetrics and Gynaecology. Oxford University Press,2020. — 928 p.. 2020
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