Loo Guo Hou, Wan Mat Wan R, Muhammad Rohaizak, Azman Mawaddah
Department of General Surgery, Faculty of Medicine, The National University of Malaysia, Bandar Tun Razak, WP Kuala Lumpur, Malaysia.
Department of Anaesthesiology and Intensive Care, Faculty of Medicine, The National University of Malaysia, Bandar Tun Razak, WP Kuala Lumpur, Malaysia.
BMJ Case Rep. 2019 Aug 4;12(8):e229763. doi: 10.1136/bcr-2019-229763.
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. As pregnancy may exacerbate asthma attacks, parturient presenting with wheezing or shortness of breath will commonly be treated as suffering from an asthmatic attack. 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. 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.
妊娠期急性气道梗阻的处理仍然是一项挑战。未能进行恰当及时的气道管理可能导致孕产妇发病和死亡，如吸入性肺炎或最严重的低氧性心肺骤停。由于妊娠可能加重哮喘发作，出现喘息或呼吸急促的产妇通常会被当作哮喘发作来治疗。然而，重要的是要注意其他可能的鉴别诊断。甲状腺疾病在育龄女性中相对常见。甲状腺在孕期会发生一些变化，这可能导致功能改变以及腺体肿大，并引起上气道梗阻和类似于支气管哮喘发作的症状。考虑到这一点，我们报告一例妊娠中期患有长期甲状腺肿的产妇，她因急性呼吸道症状和心肺骤停前来我院就诊。
