Chest pain and dyspnoea in a young primiparous woman following prolonged labour at a remote Australian community health centre

We report a rare respiratory complication in a young primiparous woman following a very prolonged labour in a remote community hospital. A 23 year old Caucasian primiparous presented with chest pain, dyspnoea and subcutaneous emphysema of the neck and chest after a very prolonged second stage of labour lasting for about 3 to 4 hours. A chest radiograph revealed evidence of pneumomediastinum. The pathophysiology is thought to be secondary to significant raise in intrapulmonary pressures leading to disruption of alveolar walls and entry of air into the pulmonary interstitium.