TY - CHAP M1 - Book, Section TI - Unanticipated Difficult Airway in an Obstetrical Patient Requiring an Emergency Cesarean Section A1 - Muir, Holly A. A2 - Hung, Orlando R. A2 - Murphy, Michael F. PY - 2017 T2 - Hung's Difficult and Failed Airway Management, 3e AB - A 25-year-old primigravida at 39-week gestational age presents to the case room with ruptured membranes and frequent uterine contractions. She does not want to have epidural analgesia because of a story she heard about an epidural complication suffered by one of her distant relatives. After 14 hours of labor, augmented with oxytocin, and now 2 hours of pushing, she is urgently taken to the operating room for emergency cesarean section because of prolonged late decelerations. She weighs 253 lb (115 kg) and is 5′3″ (160 cm) tall, giving her a BMI of approximately 45 kg·m−2. Airway examination on admission revealed a Mallampati II and a thyromental distance of 4 cm. She has a full neck extension with normal dentition and a normal mouth opening. On arrival in the operating room her Mallampati score was now assessed to be III. She has large gravid breasts. Her blood pressure is 128/68 mm Hg, heart rate 100 beats per minute (bpm), respiration rate 20 breaths per minute, and SaO2 of 99% on a 100% O2 rebreathing face mask. On arrival in the operating room, the fetal heart rate is 80 bpm. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/20 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1146619644 ER -