Research & Innovation in Anesthesia

Register      Login

VOLUME 7 , ISSUE 2 ( July-December, 2022 ) > List of Articles


Anesthesia Consideration of an Impending Thyroid Storm Patient undergoing Emergency Suction Evacuation for Bleeding Molar Pregnancy

Anju Paul, Saloni K Shah, Indrani Hemantkumar Chincholi, Syama Syamala

Keywords : Anesthesia, Hyperthyroidism, Molar pregnancy, Thyroid storm

Citation Information : Paul A, Shah SK, Chincholi IH, Syamala S. Anesthesia Consideration of an Impending Thyroid Storm Patient undergoing Emergency Suction Evacuation for Bleeding Molar Pregnancy. Res Inno Anesth 2022; 7 (2):59-61.

DOI: 10.5005/jp-journals-10049-2015

License: CC BY-NC 4.0

Published Online: 22-10-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Background: Thyrotoxicosis associated with molar pregnancy is rare to see, and anesthesia management of such patients for the emergency procedure is extremely challenging. Case description: A 22-year-old primigravida with 17 weeks of amenorrhea presented with bleeding per vaginum and pain abdomen, diagnosed as molar pregnancy, posted for emergency suction evacuation. Primary examination and lab investigation showed features of thyrotoxicosis, and the Burch–Wartofsky score was highly suggestive of an impending thyroid storm. The endocrinologist advised the evacuation of molar pregnancy as it is the definitive management of thyrotoxic state in this condition, and optimum stabilization after initiation of an antithyroid drug is still not known. The patient was given preoperative β-blockers and steroids. The suction evacuation was done under low-dose spinal anesthesia successfully. The patient was symptomatically better and discharged after 1 week. Conclusion: Knowledge of dangerous complications of molar pregnancy and safe anesthesia choices are important for an anesthesiologist for successful perioperative management of such patients.

PDF Share
  1. Yoshimura M, Hershman JM. Thyrotropic action of human chorionic gonadotropin. Thyroid 1995;5(5):425–434. DOI: 10.1089/thy.1995.5.425
  2. Pekary AE, Jackson IM, Goodwin TM, et al. Increased in vitro thyrotropic activity of partially sialated human chorionic gonadotropin extracted from hydatidiform moles of patients with hyperthyroidism. J Clin Endocrinol Metab 1993;76(1):70–74. DOI: 10.1210/jcem.76.1.8421106
  3. Chiniwala NU, Woolf PD, Bruno CP, et al. Thyroid storm caused by a partial hydatidiform mole. Thyroid 2008;18(4):479–481. DOI: 10.1089/thy.2007.0212
  4. Carroll R, Matfin G. Endocrine and metabolic emergencies: thyroid storm. Ther Adv Endocrinol Metab 2010;1(3):139–145. DOI: 10.1177/2042018810382481
  5. Tay S, Khoo E, Tancharoen C, et al. Beta-blockers and the thyrotoxic patient for thyroid and non-thyroid surgery: a clinical review. OA Anaesthetics 2013;1(1):5. DOI: 10.13172/2052-7853-1-1-491
  6. Papi G, Corsello SM, Pontecorvi A. Clinical concepts on thyroid emergencies. Front Endocrinol (Lausanne) 2014;5:102. DOI: 10.3389/fendo.2014.00102
  7. Khanna P, Kumar A, Dehran M. Gestational trophoblastic disease with hyperthyroidism: anesthetic management. J Obstet Anaesth Crit Care 2012;2(1):31–33. DOI: 10.4103/2249-4472.99315
  8. Samra T, Kaur R, Sharma N, et al. Peri-operative concerns in a patient with thyroid storm secondary to molar pregnancy. Indian J Anaesth 2015;59(11):739–742. DOI: 10.4103/0019-5049.170035
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.