Where should chest tube placement occur in a pregnant patient compared to a non-pregnant patient?

In pregnant patients, the diaphragm is elevated due to the growing uterus, which pushes the abdominal contents upwards as the pregnancy progresses. This anatomical change means that the lungs and the thoracic cavity are somewhat compressed, leading to a relative upward shift in the location of the lung apex compared to non-pregnant individuals.

When performing chest tube placement, it is crucial to consider these anatomical differences to ensure proper drainage of pleural fluid or air. By placing the chest tube 1-2 spaces higher in a pregnant patient, the clinician can ensure that the tube is positioned correctly within the pleural space, avoiding placement in a space where the lung may not be adequately accessible. This adjustment compensates for the displacement of thoracic structures caused by the pregnancy.

This technique is important not only for effective treatment but also to reduce the risk of complications associated with improper placement, such as damage to vital structures that may be encountered if the tube is placed too low.