Obstructive retrosternal goitre mimicking severe bronchial asthma in pregnancy.

BMJ Case Reports
Guo Hou LooMawaddah Azman

Abstract

Acute airway obstruction in pregnancy remains a challenge to manage. Failure of appropriate and timely airway management may lead to maternal morbidity and mortality such as aspiration pneumonitis or worst hypoxaemic cardiopulmonary arrest. 1 As pregnancy may exacerbate asthma attacks, parturient presenting with wheezing or shortness of breath will commonly be treated as suffering from an asthmatic attack. 2 However, it is important to note other possible differential diagnoses. Thyroid disease is relatively common in women of childbearing age. The thyroid gland undergoes several changes during pregnancy, which may lead to altered function as well as gland enlargement and cause upper airway obstruction and symptoms similar to a bronchial asthma attack. 3 4 With that in mind, we report a case of a parturient with long-standing goitre in her second trimester who presented to our institution with acute respiratory symptoms and cardiopulmonary arrest.

References

Sep 2, 1999·Anaesthesia and Intensive Care·A W ReidL M Wilkinson
Aug 24, 2004·International Journal of Obstetric Anesthesia·N NandwaniA E May
Aug 31, 2004·American Journal of Otolaryngology·Todd W PrestonBrendan C Stack
Oct 11, 2005·Critical Care Medicine·Uma MunnurMaya S Suresh
Nov 2, 2005·Obstetrics and Gynecology·Vanessa E MurphyVicki L Clifton
Feb 21, 2006·Thyroid : Official Journal of the American Thyroid Association·K AloumanisC H Kostopoulos
May 20, 2009·Archives of Surgery·Sreyram KuyJulie Ann Sosa

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