Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA 02114, USA.
Int J Obstet Anesth. 2012 Jul;21(3):273-6. doi: 10.1016/j.ijoa.2012.04.003. Epub 2012 May 31.
Airway stenosis in pregnancy is challenging and the literature does not offer consensus regarding its evaluation and anesthetic management. A 21-year-old nulliparous woman with ectodermal dysplasia and severe glottic stenosis was referred to the obstetric anesthesia team for evaluation and peripartum management recommendations. She had a history of a congenital complete glottic web that required a tracheostomy at birth. After decannulation at age four, she was lost to follow-up. On examination in early pregnancy, she was found to have a dangerously narrow airway with fixed vocal cords and a glottic aperture of 2-3mm. At nine weeks of gestation an elective tracheostomy was performed under local anesthesia. She later underwent an uneventful cesarean delivery under spinal anesthesia. Ultimately, early interdisciplinary planning for an elective tracheostomy helped assure patient safety during advancing pregnancy and delivery.
妊娠合并气道狭窄极具挑战性，相关文献对于其评估和麻醉管理尚未达成共识。一位 21 岁、无生育史的女性，患有外胚层发育不良和严重声门狭窄，被转介至产科麻醉团队，以获得评估和围产期管理建议。她出生时患有先天性完全性声门蹼，需要行气管切开术。4 岁时拔管后，她就不再接受随访。孕早期检查时，发现她的气道非常狭窄，声带固定，声门裂仅 2-3mm。妊娠 9 周时，在局部麻醉下行择期气管切开术。后来，她在脊髓麻醉下顺利进行了剖宫产术。最终，早期进行气管切开术的多学科规划有助于确保患者在妊娠和分娩期间的安全。
