Thoracic ultrasound improves outcome in pregnant woman with severe asthma and respiratory failure

Severe asthma during pregnancy presents significant management challenges, particularly when complicated by respiratory failure. We report the case of a 26-year-old pregnant woman with a history of severe allergic asthma who experienced a severe asthma exacerbation during her third trimester after discontinuing Benralizumab therapy. The patient, who had also recently contracted a SARS-CoV-2 infection, presented with worsening dyspnea and hypoxemia. Despite high-flow oxygen therapy and bronchodilators, her condition deteriorated, necessitating transfer to intensive care. Thoracic ultrasound, a non-invasive and radiation-free diagnostic tool, played a pivotal role in monitoring lung condition and guiding treatment, revealing pleural effusions and subpleural consolidations. Antibiotic therapy and the resumption of Benralizumab led to gradual clinical improvement. The patient delivered a healthy baby, and thoracic ultrasound confirmed full recovery. This case highlights the utility of thoracic ultrasound in managing severe respiratory failure in pregnant women, minimizing fetal risk while providing critical diagnostic information. The case also raises important considerations regarding the influence of viral infections such as SARS-CoV-2 and Zika virus on asthma exacerbations and lung function. (www.actabiomedica.it).