Abstract
Pregnant women sometimes have thyroid disease, and thus goiter; however, it does not become so large to the extent that the goiter obstructs the air way, causing respiratory symptoms. Here, we report such a case. A 27-year-old woman with large goiter presented with life threatening stridor at 37 weeks. After a multidisciplinary-team discussion, we performed caesarean section plus thyroidectomy, which resulted in good outcomes. Histological examination revealed hyperplasia and not malignancy. The postoperative course was uneventful. The mother and infant were healthy.
Highlights
Thyroid disease is common in pregnancy, with pre-existing hyper- or hypothyroidism being present in up to 4% of pregnancies
We describe the successful management of a pregnant woman with severe thyroid disease
Combined procedure involving caesarean section followed by total thyroidectomy under general anesthesia. This decision took into account the fact that the pregnancy was term, the woman had a low likelihood of tolerating labor, due to the tracheal compression producing severe respiratory compromise even at rest
Summary
Thyroid disease is common in pregnancy, with pre-existing hyper- or hypothyroidism being present in up to 4% of pregnancies. Owing to the structural analogy of the α subunit of βhCG to thyroid stimulating hormone, production of T4 and T3 is greatly enhanced. This enhanced thyroid stimulation results in relative hypothyroxinemia in women with insufficient dietary Iodine (
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