Pregnancy & Stenosis
It is possible to become pregnant and start a family with tracheal stenosis - many patients have successfully had children with this condition.
However, for unknown reasons, pregnancy also seems to be a trigger in some patients. Since most people affected by idiopathic subglottic stenosis are women, estrogen is suspected to play a role in its development. Not surprisingly, estrogen levels increase during pregnancy. It can be scary to struggle with this condition during pregnancy, but the good news is that it can usually be successfully treated.
Once the pregnancy is confirmed, you should inform your gynecologist about the stenosis.
During pregnancy, many women experience an accelerated growth of the stenosis, but it can be easily widened, especially from the second trimester onwards. Close monitoring approximately every 3 months or as needed is certainly advisable.
In our online self-help forum, some of those affected have reported on their pregnancies. During pregnancy, the women with shortness of breath fared differently. The children were not affected by the stenosis.
A tracheotomy is usually neither necessary nor advisable during pregnancy, as it would be too stressful! If a surgeon or obstetrician wants to perform a tracheotomy just because you are pregnant, you should definitely get a second opinion. Your health and that of your baby come first.
Since we always have enough oxygen saturation in our blood, the baby is adequately supplied during pregnancy, even if the trachea is severely narrowed. Our red blood cells always ensure that there is enough oxygen in the blood, even if rapid and deep breathing is made difficult by the stenosis.
During pregnancy, you can also try to make the stenosis more bearable or slow down the growth with a cortisone spray . Or you can try outpatient steroid injections , even if these are not yet very common in this country. Both have proven effective in pregnancy (especially for asthma patients) and are generally considered safe during pregnancy.
Otherwise, dilation is possible during pregnancy. The recommended time is between 20 and 24 weeks of pregnancy, but it depends on the individual situation. The timing is also influenced by other factors, especially the airway and shortness of breath. If the trachea is really narrow and breathing is poor, there is little point in trying to force it through, even during pregnancy. It is important to remember that a carefully planned dilation is usually much safer than emergency ventilation and/or surgery (especially if outpatient steroid injections are not available).
If you are turned away from the clinic treating you during pregnancy, you should contact an experienced clinic . There are not many who are confident in treating you during pregnancy and only a few have experience of doing so. Even gynecologists and obstetricians may never have seen anyone with subglottic tracheal stenosis. This is something to consider when looking for advice and treatment options.
Even if no other problems arise during pregnancy other than the stenosis, it may be advisable to have the birth in hospital. If surgery is necessary for the birth, there is still the risk of intubation and special anesthesiological care in the operating room.
It is certainly advisable to carry an emergency card with brief information about the stenosis and the pregnancy, with advice on what to do with the airway in an emergency. This usually includes suggestions on how to avoid intubation and how to use a small tube (usually 4.5-5.5) if intubation becomes necessary.
Try to relax! It can be stressful and frightening to deal with this illness during pregnancy. But don't worry too much. The exchange in self-help groups is good and can help you, especially in stressful situations.
You can find detailed information about pregnancy with tracheal stenosis in Catherine Anderson's guide.