An Interdisciplinary Approach to the Management of Idiopathic Subglottic Stenosis in Pregnancy

Background: Idiopathic subglottic stenosis (ISS) accounts for 18.5% of acquired causes of subglottic stenosis in adults. To date, there have been 11 cases reported of ISS in pregnancy. ISS in pregnancy poses a diagnostic challenge due to the presentation of symptoms similar to other airway conditions without a clear underlying cause. Case: We report a case of pregnant women who presented with progressive respiratory distress due to severe subglottic stenosis causing significant airway obstruction in her 2nd trimester pregnancy. An awake tracheostomy was carried out at 28 weeks followed by an elective cesarean section at term. Beginning two months postpartum, successful serial balloon dilations led to resolution of the restenosis and subsequent decannulation of the tracheostomy and resolution of the problem. Conclusion: This case highlights the importance of considering ISS in a pregnant patient with upper respiratory symptoms as well as the team collaboration needed to diagnose and manage the patient’s airway.