Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA.
University of Utah School of Medicine, Salt Lake City, UT, USA.
Ann Otol Rhinol Laryngol. 2021 Feb;130(2):188-194. doi: 10.1177/0003489420947780. Epub 2020 Aug 8.
(1) To determine how pregnancy affects idiopathic subglottic stenosis (iSGS) symptoms. (2) To determine treatments utilized (including operating room (OR) and in-office procedures) for iSGS before, during, and after pregnancy.
A 24-question survey was distributed to an international iSGS support group to assess the patient experience among individuals who have been pregnant with diagnosis of iSGS. Descriptive statistics and chi analyses were completed.
A total of 413 iSGS patients participated; 84.7% (n = 350) of patients were diagnosed to menopause. A total of 25.5% patients reported being pregnant when they had airway stenosis; 71.1% of those reported more severe airway symptoms during pregnancy. The proportion of patients that reported requiring ≥1 OR interventions (microlaryngoscopy and bronchoscopy, laser, balloon dilation, or steroid injection) before, during and after pregnancy was the following, respectively: 37.3%, 35.6%, 51.3%. Whereas the proportion of patients that reported requiring ≥1 in-office interventions (awake balloon dilation or steroid injection) before, during and after pregnancy was the following, respectively: 13.6%, 11.8%, 15.8%. Number of pregnancies and age of diagnosis was not related to severity of symptoms or requiring more airway interventions ( > .05).
This survey reveals worsening of symptoms during pregnancy, however, this did not lead to increase in operative or clinic interventions to improve airway symptoms during pregnancy. Future avenues for research include optimizing management of airway symptoms during pregnancy to limit OR-based interventions.
Level IV.
(1) 确定妊娠如何影响特发性声门下狭窄(iSGS)症状。(2) 确定在妊娠前、妊娠期间和妊娠后用于 iSGS 的治疗方法(包括手术室(OR)和门诊程序)。
向国际 iSGS 支持小组分发了一份 24 个问题的调查问卷,以评估患有 iSGS 诊断的孕妇的患者体验。完成了描述性统计和卡方分析。
共有 413 名 iSGS 患者参与;84.7%(n=350)的患者被诊断为绝经后。25.5%的患者报告在气道狭窄时怀孕;71.1%的患者报告在怀孕期间气道症状更严重。报告在妊娠前、妊娠期间和妊娠后需要至少 1 次 OR 干预(显微镜检查和支气管镜检查、激光、球囊扩张或类固醇注射)的患者比例分别为:37.3%、35.6%、51.3%。而报告在妊娠前、妊娠期间和妊娠后需要至少 1 次门诊干预(清醒球囊扩张或类固醇注射)的患者比例分别为:13.6%、11.8%、15.8%。怀孕次数和诊断年龄与症状严重程度或需要更多气道干预(>.05)无关。
本调查显示怀孕期间症状恶化,但这并没有导致增加手术或门诊干预以改善怀孕期间的气道症状。未来的研究方向包括优化妊娠期间气道症状的管理,以限制基于 OR 的干预措施。
IV 级。