Abstract
BackgroundPregnancy constitutes a significant factor in thyroid hypertrophy and can rarely progress to respiratory distress. We describe case of pregnant woman with acute respiratory distress following a tracheal compression due to goiter, quickly resulting in respiratory arrest, requiring emergency orotracheal intubation and thyroidectomy.Case presentationA pregnant woman with a growing goiter was referred to the hospital with a respiratory difficulty. During the examination, we found a large homogeneous goiter. The patient showed signs of respiratory exhaustion with bradypnea and pulmonary auscultation revealing decreased ventilation of the two pulmonary fields. The evolution quick led to respiratory arrest. The patient was rapidly intubated, which saved her.A thoracic computed tomography was performed and revealed a large goiter, compressing the trachea in its thoracic area and oppressing the vascular structures. Obstetrical ultrasound was normal. Thyroidectomy was decided after the patient’s preparation. After 24 h, the patient was successfully extubated without incident and the postoperative period was uneventful.ConclusionAirway obstruction during pregnancy secondary to goiter is rare but can be fatal. Early diagnosis might have avoided the evolution towards the respiratory failure. Prevention requires early surgery preferably before pregnancy or in our case a surgery in the second trimester.
Highlights
Pregnancy constitutes a significant factor in thyroid hypertrophy and can rarely progress to respiratory distress
As the case described by Aloumanis and al., this compression may be the cause of acute respiratory failure, especially in the presence of a delayed etiological diagnosis, requiring an urgent thyroidectomy, [3]
We describe an unusual case of a pregnant woman, suffering from acute respiratory distress following a tracheal compression by goiter
Summary
Airway obstruction in pregnancy secondary to goiter is rare but can be fatal. Diagnosis in our patient during her first consultation could have prevented the evolution towards a respiratory arrest. Prevention requires early surgery better before pregnancy or in our case, in the second trimester, to avoid endanger the life of the mother and the fetus. Acute increase in goiter size during a normal pregnancy: an exceptional case report. 3. Aloumanis K, Mavroudis K, Vassiliou I, Arkadopoulos N, Smyrniotis V, Kontoyannis S, et al Urgent thyroidectomy for acute airway obstruction caused by a goiter in a euthyroid pregnant woman. Goitre prevalence in pregnant women attending antenatal clinic in a teaching hospital. Haemorrhage of a thyroid cyst as an unusual complication of intubation. Extracoporeal menbrane oxygenation assisted resection of goiter causing severe extrinsic airway compression.
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