The case presented details an uncommon case of subglottic tracheal stenosis exacerbated by pregnancy. We outine the multidisciplinary management involved and the outcomes for the pregnancy. The case serves as a reminder that shortness of breath in pregnancy has a broad differential diagnosis, and stridor is always abnormal.
KolarzykESzotWMLyxzczarzJ.Lung function and breathing regulation parameters during pregnancy. Arch Gynecol Obstet2005;
272: 53–58.
2.
McAuliffeFKametasNCostelloJ, et al.
Respiratory function in singleton and twin pregnancy. BJOG2002;
109: 765–769.
3.
SchatzMZeigerRSHoffmanCP.Intrauterine growth is related to gestational pulmonary function in pregnant asthmatic women. Kaiser-Permanente Asthma and Pregnancy Study Group. Chest1990;
98: 389–392.
4.
SchatzMDombrowskiMPWiseR, et al.
Spirometry is related to perinatal outcomes in pregnant women with asthma. Am J Obstet Gynecol2006;
194: 120–126.
BournSMilliganPMcNarryAF.Use of transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) to facilitate the management of subglottic stenosis in pregnancy. Int J Obstet Anesth2020;
41: 108–113.
7.
ScholzASrinivasKStaceyMRW, et al.
Subglottic stenosis in pregnancy. Br J Anaesth2008;
100: 385–388.
8.
SutcliffeNRemingtonSAMRamsayTM, et al.
Severe tracheal stenosis and operative delivery. Anaesthesia1995;
50: 26–29.
9.
RatnerEFCohenSEEl SayedY, et al.
Mask induction with sevoflurane in a parturient with severe tracheal stenosis. Anesthesiology2001;
95: 553–555.
10.
SalamaDJBodySC.Management of a term parturient with tracheal stenosis. Br J Anaesth1994;
72: 354–357.
11.
EngelNMAAGramkeHFPeetersL, et al.
Combined spinal-epidural anaesthesia for a woman with Wegener’s granulomatosis with subglottic stenosis. Int J Obstet Anesth2011; 20: 94–95. DOI: 10.1016/j.ijoa.2010.07.003.
12.
CarnessJMBermanJL.Awake microlaryngoscopy and serial balloon dilation in a third trimester multigravida with subglottic tracheal stenosis: anesthetic implications. A. A&A Case Rep2014;
3: 166–168.
13.
NashZKrishnaADarwishM, et al.
Conservative management of subglottic stenosis in pregnancy resulting in vaginal birth. BMJ Case Rep2014;
3. DOI: 10.1136/bcr-2013-202137.
14.
SmithMMCottonRT.Diagnosis and management of laryngotracheal stenosis. Expert Rev Respir Med2018;
12: 709–717.
15.
PillaiAChikhaniMHardmanJG.Apnoeic oxygenation in pregnancy: a modelling investigation. Anaesthesia2016;
71: 1077–1080.
16.
PatelANouraeiSAR.Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE): a physiological method of increasing apnoea time in patients with difficult airways. Anaesthesia2015;
70: 323–329.
17.
HermezLASpenceCJPaytonMJ, et al.
A physiological study to determine the mechanism of carbon dioxide clearance during apnoea when using transnasal humidified rapid insufflation ventilatory exchange (THRIVE). Anaesthesia2019;
74: 441–449.
18.
DamroseEJMansonLNekhendzyV, et al.
Management of subglottic stenosis in pregnancy using advanced apnoeic ventilatory techniques. J Laryngol Otol2019;
133: 399–403.
19.
KarippacherilJGGoneppanavarUPrabhuM, et al.
Idiopathic subglottic stenosis in pregnancy: a deceptive laryngoscopic view. Indian J Anaesth2011;
55: 521–523.