Sudden life-threatening laryngeal edema in pregnancy: a case report

Journal of Medical Case Reports

Case Report

Adhrie Sugiarto¹  Vincent Chrisnata²  Erniody Erniody³  Aldy Sethiono³ 

[1]Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Ciptomangunkusumo Hospital, Jakarta, Indonesia

[2]Department of Anesthesiology and Intensive Care, Faculty of Medicine, Universitas Indonesia, Ciptomangunkusumo Hospital, Jakarta, Indonesia

[3]Department of Anesthesiology and Intensive Care, Husada Hospital, Jakarta, Indonesia

[4]Department of Anesthesiology and Intensive Care, Husada Hospital, Jakarta, Indonesia

关键词: Laryngeal edema;    Preeclampsia;    Intensive care unit;    Cesarean section;    Case report;   

DOI  :  10.1186/s13256-023-03880-7

 received in 2022-12-28, accepted in 2023-03-07,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSevere laryngeal edema during pregnancy is uncommon but can be encountered, particularly in patients with preeclampsia accompanied by other comorbidities. Careful consideration must be given to balance the urgency of securing the airway with the safety of the fetus and the patient’s long-term health consequences.Case presentationA 37-year-old Indonesian woman was brought to the emergency department at 36 weeks gestation due to severe dyspnea. Her condition worsened a few hours later during intensive care unit admission, with tachypnea, decreased oxygen saturation, and inability to communicate, necessitating intubation. Due to the edematous larynx, we could only use 6.0-sized endotracheal tube. The use of a small-sized endotracheal tube was expected to be short-lived, so she was considered for tracheostomy. Nevertheless, we decided to perform a cesarean section first after lung maturation because it would be safer for the fetus, and laryngeal edema usually improves after delivery. Cesarean section was performed under spinal anesthesia for the safety of the fetus, and 48 hours after delivery, she underwent a leakage test with a positive result, so extubation was performed. Stridor was no longer audible, breathing pattern was within normal limits, and vital signs were stable. The patient and her baby both recovered well with no long-term health consequences.ConclusionThis case demonstrates that unexpected life-threatening laryngeal edema can occur during pregnancy, in which upper respiratory tract infections may trigger it. The decision between conservative and aggressive immediate airway management should be made with careful consideration of securing the patient’s airway, the safety of the fetus, and the patient’s long-term health consequences.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 5

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