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Vol. 67, No. 1, 2009
Issue release date: January 2009
Gynecol Obstet Invest 2009;67:70–72

Pneumomediastinum during the Fourth Stage of Labor

Zapardiel I. · Delafuente-Valero J. · Diaz-Miguel V. · Godoy-Tundidor V. · Bajo-Arenas J.M.
Obstetrics and Gynecology Department, Santa Cristina University Hospital, Madrid, Spain

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Postpartum spontaneous pneumomediastinum (Hamman’s syndrome) is a very rare event with an estimated incidence of 1 in 100,000 deliveries. It occurs mainly in the second stage of labor and is potentially lethal. We report the case of a 29-year-old primiparous woman during the immediate puerperium (Leff’s fourth stage of labor) presenting with acute chest pain, dyspnea and petechiae. She was admitted to the intensive care unit with a suspected diagnosis of amniotic fluid embolism. A chest radiograph revealed a pneumomediastinum that finally resolved with oxygen therapy and supportive management in 3 days.

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