Case Report: Pulmonary Aplasia in Pregnant Women

Background: Pulmonary aplasia is a rare congenital pathology in which there is unilateral or bilateral absence of lung tissue. It differs from pulmonary agenesis, since in aplasia a closed, short-blind bronchus is present. The symptoms vary from no complaints to various respiratory complaints, however, non-specific clinical features act as a barrier to diagnosis. Case Report: A 27-year-old woman, primigravide at week 12, presented with dry cough, breathing difficulty, fever 370C, slightly altered health conditions, conscious, oriented. She refers no concomitant diseases, except the frequency of "seasonal flu". Physical examination/ Radiologic examination: Retraction of the left hemithorax, dullness in percussion and diminished vocal fremitus and breath sounds on the left hemithorax base. Chest radiography: a homogenous density in the lower part of the left hemithorax with deviation of the trachea and mediastinum to the left. Echo: left hemidiaphragm without mobility during respiration, left renal agenesis. ECG: sinusal rythm, P pulmonale, RBBB. Thoracic CT: Complete atelectasis of the left lung with short-blind left main bronchus and compensatory hyperinflation of the right lung. Unique right lung with total displacement of the mediastinum left as well as hypertrophy, herniation of the right lung tissue left. It is diagnosed with left pulmonary aplasia, unique right kidney. At 36 weeks of pregnancy, dyspnea is amplified and the patient undergoes cesarean delivery with spinal anesthesia. Both mother and infant did well. Conclusion: Unilateral pulmonary aplasia without significant comorbidities may remain undiagnosed until adulthood. Pregnancy and childbirth are successful with multidisciplinary assistance.