Recurrent Idiopathic Subglottic Stenosis in Multiple Pregnancies: A Case Report
Bibliographic record
Abstract
Introduction: Idiopathic subglottic stenosis (ISS) is a type of central airway obstruction primarily affecting adult Caucasian females. Its rarity and similar clinical presentation to asthma contribute to its frequent misdiagnosis. Timely treatment of ISS is crucial for pregnant patients who are at risk for emergent surgeries necessitating ventilation and intubation. Case: A 29-year-old, previously healthy female reported new onset dyspnea on exertion and a dry, non-productive cough to her family physician. Clinical exam was unremarkable; however, pulmonary function testing revealed a moderate, fixed airway obstruction. Endoscopy visualized subglottic stenosis 1.7 cmdistal to her vocal cords and surgical intervention using CO2 laser dilatation was scheduled with Otolaryngology. However, the patient received a positive pregnancy test prior to her elective surgery dateand after consideration of risks and benefits to mother and fetus, the surgery was postponed to her second trimester. Unfortunately, the patient miscarried her fetus and was scheduled for an emergent dilatation and curettage (D&C). She was successfully bag-mask ventilated during the D&C and subsequently underwent surgery for ISS with full resolution of her symptoms. In subsequent follow-up, the patient reported a return of dyspnea coinciding with another positive pregnancy test. ISS recurrence was diagnosed; however, as symptoms were mild, a repeat surgery was postponed until the patient safely delivered her child. Discussion: This case illustrates the difficulties in the diagnosis and management of ISS in pregnant patients during their childbearing years as surgical intervention will impact both the mother and fetus.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".