Neglected massive multinodular goiter during pregnancy with dyspnea and successful normal delivery: A case report

Abstract

Key Clinical MessagePrompt coordinated care enables vaginal delivery for severe goiter‐induced airway compression in late pregnancy when expectant management is precluded.AbstractLong‐standing neglected multinodular goiter rarely causes life‐threatening airway compression in late pregnancy. Most cases report cesarean delivery to relieve respiratory distress. Vaginal birth may also be possible, but the evidence is limited. A 30‐year‐old woman with a 7‐year goiter history developed severe dyspnea at 34 weeks gestation. Despite the risks, labor was induced by urgent decompression. She vaginally delivered a premature but healthy infant. Her breathing improved after delivery. She later underwent an uncomplicated thyroidectomy. With careful selection and monitoring, vaginal delivery can be considered for goiter‐induced respiratory compromise when expectant management is precluded. This case demonstrates successful urgent decompression and favorable maternal‐fetal outcomes are possible with a coordinated approach despite the high‐risk scenario.