Pneumomediastinum during the fourth stage of labor

Gynecol Obstet Invest. 2009;67(1):70-2. doi: 10.1159/000162103. Epub 2008 Oct 9.


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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Embolism, Amniotic Fluid / diagnosis
  • Embolism, Amniotic Fluid / pathology
  • Female
  • Humans
  • Infant, Newborn
  • Male
  • Mediastinal Emphysema / diagnosis
  • Mediastinal Emphysema / diagnostic imaging
  • Mediastinal Emphysema / etiology
  • Mediastinal Emphysema / pathology*
  • Mediastinal Emphysema / therapy
  • Obstetric Labor Complications / diagnosis
  • Obstetric Labor Complications / pathology*
  • Obstetric Labor Complications / therapy
  • Oxygen / therapeutic use*
  • Pregnancy
  • Radiography


  • Oxygen