Acute airway obstruction in the puerperium secondary to massive thyroid enlargement

SummaryPregnancy is known to be thyrogenic and may exacerbate features of thyroid disease. We report the case of a patient whose pregnancy was complicated by respiratory symptoms following remarkable increase in size of a pre-existing goitre. She declined surgery during the pregnancy and it was rescheduled for after the puerperium. A week postpartum she developed acute airway obstruction which necessitated urgent thyroidectomy and management of tracheomalacia with a tracheostomy postoperatively. The effect of pregnancy on the course of her disease and the anaesthetic challenges in the face of limited airway equipment are highlighted.