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Anesth Analg 2009; 108:1246-1248
© 2009 International Anesthesia Research Society
doi: 10.1213/ane.0b013e3181979e01
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OBSTETRIC ANESTHESIOLOGY

Repeated Episodes of Respiratory Distress in an Obese Parturient After Cesarean Delivery

Bernard Wittels, MD, PhD, Tamer A. Attia, MD, Abbas Al-Qamari, MD, and Matthew P. Jaycox, MD

From the Department of Anesthesiology, Rush Medical College, Rush University Medical Center, Chicago, Illinois.

Address correspondence and reprint requests to Bernard Wittels, MD, PhD, Department of Anesthesiology, Rush Medical College, Rush University Medical Center, 1653 West Congress Parkway, Suite 739 Jelke, Chicago, IL 60612-3833. Address e-mail to bernard_wittels{at}rush.edu.

Abstract

A 25-yr-old obese parturient with mild asthma underwent an uneventful spinal anesthetic for primary cesarean delivery. Within 4 h after delivery, the patient twice developed acute shortness of breath, inspiratory stridor, and hypoxemia that required intubation. A battery of blood tests revealed no evidence of an allergic reaction. She had a normal echocardiogram and chest computed tomography, but her neck computed tomography showed an enlarged left thyroid lobe asymmetrically compressing the endotracheal tube cuff. We hypothesized that, after delivery, decreased maternal vascular capacitance increased central venous pressure such that venous engorgement of an undiagnosed goiter may have caused symptomatic tracheal compression.






Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2009 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2009 by the International Anesthesia Research Society.