Acute Exacerbation of Subglottic Stenosis in Pregnancy A Case Report

BACKGROUND: Granulomatosis with polyangiitis is a rare cause of subglottic stenosis, and there is limited literature on the evaluation and management of this condition when it occurs in pregnancy. CASE: A 37-year-old woman,P1001, at 33+5 weeks'gestation and with a history of subglottic stenosis and recently diagnosed influenza presented with respiratory distress. Bronchoscopy showed severe tracheobronchial inflammation with subglottic stenosis which necessitated insertion of a tracheostomy tube. The patient was treated with antivirals and steroids and underwent an uncomplicated cesarean delivery at 35+6 weeks' gestation.The tracheostomy was removed shortly thereafter. CONCLUSION: This case demonstrates that the respiratory status and airway patency of patients with sub-glotticstenosis is often significantly worsened in pregnancy.An inciting factor, such as an infection, may acutely provoke episodes of hypoxia, necessitating intubation or tracheostomy placement. A carefully timed delivery may be necessary if a pregnant patient with sub-glotticstenosis and respiratory compromise requiring tracheostomy placement is unable to receive optimal treatment due to pregnancy.