Airway changes following labor and delivery in preeclamptic parturients.


eMediNexus    16 December 2017

A recent study published in the International Journal of Obstetric Anesthesia evaluated the airway during and after labor in women with or without preeclampsia. This single-center, prospective, case-control study enrolled 25 normal and 25 severely preeclamptic pregnant women, in early labor, wherein airway assessment was performed before active labor; within an hour of delivery; and 24-48 hours postpartum. The primary outcome was the Mallampati grade, while secondary outcomes were sonographic measurements. The results revealed that the Mallampati score increased from the pre-labor to the post-labor period in both preeclamptic and normotensive patients. Additionally, a marked difference in tissue thickness at the hyoid level was observed between preeclamptic and normotensive patients pre-labor, post-labor, and postpartum. In contrast, no significant difference was recorded in the thyromental distance or neck circumference between the groups at any point. Whereas, a correlation could be elicited between the total duration of labor and a Mallampati change by one grade. Hence, the findings were summarized as: airway sonography may provide useful anatomical information for prediction of difficult laryngoscopy; the change in airway dimensions and the Mallampati score during labor may persist for 48-hour postpartum in both, women with or without preeclampsia; and those with prolonged labor are more vulnerable to changes in airway dimensions.

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