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Spontaneous Pneumomediastinum Presenting as Jaw Pain During Labor

Department of Obstetrics and Gynecology, University of Iowa College of Medicine, Iowa City, Iowa

Address reprint requests to: Janet I. Andrews, MD, Department of Obstetrics and Gynecology, University of Iowa College of Medicine, SW 44-14 GH, 200 Hawkins Drive, Iowa City, IA 52242; E-mail: janet-andrews{at}uiowa.edu.

BACKGROUND: Pneumomediastinum, or presence of free air within the mediastinum, is a rare complication of labor. Common symptoms of this condition include chest pain, dyspnea, and subcutaneous emphysema.

CASE: A woman complained of right jaw pain 90 minutes after the onset of her second stage of labor. On examination, she was found to have swelling and crepitus over her face, neck, and supraclavicular region. A chest radiograph demonstrated a pneumomediastinum, which resolved spontaneously.

CONCLUSION: Pneumomediastinum is associated with Valsalva maneuvers such as those seen during the second stage of labor. We report jaw pain as an unusual presenting symptom of this rare condition. Familiarity with the presenting symptoms of a pneumomediastinum is imperative for appropriate treatment and monitoring for significant complications.

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				J. B. Jougon, M. Ballester, F. Delcambre, T. Mac Bride, C. E. H. Dromer, and J.-F. Velly Assessment of spontaneous pneumomediastinum: experience with 12 patients Ann. Thorac. Surg., June 1, 2003; 75(6): 1711 - 1714. [Abstract] [Full Text] [PDF]