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05 September 2023 : Case report  Belgium

[In Press] Protracted Labor Complicated by Pneumomediastinum and Subcutaneous Emphysema: A Rare Case Report and Management Considerations

Challenging differential diagnosis, Rare disease

Ait Amara Inesse1E, Ruggiano Ilaria1E, Olivier Camille1D

DOI: 10.12659/AJCR.940989

Am J Case Rep In Press; DOI: 10.12659/AJCR.940989  

Available online: 2023-09-05, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule


Spontaneous pneumomediastinum and subcutaneous emphysema (Hamman’s syndrome) presents with sudden and life-threatening symptoms. Clinical signs include crackles that synchronize with the heartbeat on chest auscultation (Hamman’s sign). This report describes the case of a 29-year-old woman with a protracted second stage of labor at 40 weeks of pregnancy with postpartum dyspnea, acute chest pain, and surgical emphysema due to pneumomediastinum (Hamman’s syndrome).
This case report describes the case of a 29-year-old primigravida admitted to the hospital ward for spontaneous labor at 40 weeks of pregnancy. Due to a protracted second stage of labor, the delivery was assisted by Thierry’s spatulas. Shortly after delivery, the patient developed dyspnea associated with subcutaneous emphysema in the inferior part of the face, neck, and anterior chest wall. As the clinical evaluation showed no signs of severity, we performed a chest X-ray, which confirmed the diagnosis of pneumomediastinum (Hamman’s syndrome), excluded any other life-threatening condition, and led to a conservative treatment approach.
This report presents a rare association between protracted labor and Hamman’s syndrome and highlights the importance of rapid diagnosis and management. In this case, the postpartum presentation was distinguished from pulmonary embolism, and emergency life-saving management was initiated.

Keywords: Dyspnea; Mediastinal Emphysema; Subcutaneous Emphysema

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923