Pulmonary infection may result in respiratory arrest, especially in cases of systemic sepsis. Non-bacterial pneumonia such as Mycoplasma and Pneumocystis are usually insidious infections and rarely present with acute respiratory arrest. Pulmonary infection secondary to uterine perforation or severe chorioamnionitis are a special circumstance, and are more likely to present as acute pulmonary failure and coagulopathy. Respiratory arrest from peripartum cardiomyopathy is commonly the result of progressive, classic cardiac failure with gradual onset of tachypnea, dyspnea, and orthopnea. This cardiomegaly commonly associated with cardiomyopathy may be mistaken as physiologic heart enlargement on chest radiograph.
Adult echocardiography is the preferred method of diagnosis.
The blood pressure will be high in patients with pre-eclampsia, but low in patients with untreated cardiomyopathy or sepsis. Fever of greater than 102 F is uncommon during pregnancy, except in the presence of bacterial infection. The chest exam will usually reveal localized or diffuse rales. A non-productive cough is common. CVA tenderness is found if patients have the post-pyelonephritis respiratory distress syndrome.