Obstetric airway management presents unique challenges due to anatomical and physiological changes during pregnancy, such as increased weight, breast size, airway edema, and higher oxygen consumption, which elevate the risk of difficult or failed intubation. The incidence of difficult intubation in obstetrics is significantly higher than in non-obstetric cases, with a rate of 1 in 21 versus 1 in 50, respectively. Key factors contributing to this difficulty include age, BMI, and Mallampati score. Effective management involves thorough preoperative assessment, optimal patient positioning (e.g., 20-30 degree head-up tilt), adequate preoxygenation, and preparation for potential complications like pulmonary aspiration. Guidelines recommend the use of videolaryngoscopes and having contingency plans for unanticipated difficult airways, including awake fiberoptic intubation in controlled settings when possible. In cases of failed intubation and oxygenation, front-of-neck access techniques may be necessary, emphasizing the importance of training and preparedness among anesthesiologists. Postoperatively, vigilance continues until the patient fully recovers and can maintain her airway.
Basic Mechanical Ventilation 2024
February 7, 2025
