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Case Reports
. 2023 Apr 20;17(1):180.
doi: 10.1186/s13256-023-03880-7.

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

Vincent Chrisnata  1   2 , Adhrie Sugiarto  3 , Erniody Erniody  4 , Aldy Sethiono  4
Affiliations
Case Reports

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

Vincent Chrisnata et al. J Med Case Rep. .

Abstract

Background: Severe 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 presentation: A 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.

Conclusion: This 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.

Keywords: Case report; Cesarean section; Intensive care unit; Laryngeal edema; Preeclampsia.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Bronchoscopy findings showing laryngeal edema with multiple white plaques
Fig. 2
Fig. 2
Patient undergoing spinal anesthesia while still on ETT
See this image and copyright information in PMC

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