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Pneumomediastinum, free air trapped in the mediastinal connective tissue, is a rare complication of pregnancy, occurring most frequently in the second stage of labor. Symptoms are often not noted until after delivery. Occurrence before and in the first stage of labor, as seen in the two cases reported here, is more uncommon. One case history is the first report of the coexistence of pneumomediastinum and pneumothorax in pregnancy. The prognosis for spontaneous pneumomediastinum in pregnancy is favorable. Pathophysiologic mechanisms, diagnosis, and management are discussed, and a review of the literature is presented.

Peripartum cardiomyopathy is a myocardial disease of a dilatative (congestive) nature which typically presents in the last month of pregnancy or within the first 5 postpartum months. In the first case described, heart failure was noted prior to delivery, and complete recovery was achieved with early and aggressive management. Cardiomyopathy developed postpartum in the second case, with a fatal outcome. Early diagnosis and prompt treatment are of paramount importance. Mortality is still high. Recent pathologic findings, methods of diagnosis and theories on etiology are discussed.