Wheeze in pregnancy: Sometimes a pain in the neck to diagnose

Background: Upper airway obstruction can present with stridor or wheeze and is sometimes misdiagnosed as asthma. As asthma is common amongst pregnant women, upper airway obstruction can remain hidden. Case: We describe the case of goitre-related life threatening upper airway obstruction which was initially thought to be poorly controlled asthma in a pregnant woman. Careful history, high clinical suspicion and directed imaging was required to make the diagnosis. A multi-disciplinary team and meticulous planning was required to safely treat the parturient. Conclusion: As asthma has an incidence of 3%-12% among pregnant woman; wheezing is likely to be diagnosed as asthma. Our case illustrates the importance of detailed history, examination and imaging in the parturient who presents with wheeze. It also highlights the added complexity of managing a patient with a life threatening airway problem while she is pregnant.