TY - CHAP M1 - Book, Section TI - Unanticipated Difficult Airway in an Obstetrical Patient Requiring an Emergency Cesarean Section A1 - Ratto, Christina A1 - Muir, Holly A. A2 - Hung, Orlando R. A2 - Murphy, Michael F. PY - 2024 T2 - Hung’s Management of the Difficult and Failed Airway, 4th Edition AB - A 25-year-old primigravida at 39 weeks gestational age presents to the labor and delivery floor 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 lbs (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 full neck extension with normal dentition and a normal mouth opening. On arrival in the operating room, her Mallampati score is now assessed to be a grade III. She has large gravid breasts. Her blood pressure is 128/68 mmHg, heart rate 100 beats per minute (bpm), respiratory rate 20 breaths per minute, and SaO2 of 99% on a 100% oxygen via a non-rebreather face mask. On arrival in the operating room, the fetal heart rate is 80 bpm. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/10/13 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=1202479061 ER -