TY - CHAP M1 - Book, Section TI - Chapter 51. Unanticipated Difficult Airway in an Obstetrical Patient Requiring an Emergency Cesarean Section A1 - Olufolabi, Adeyemi J. A1 - Muir, Holly A. A2 - Hung, Orlando A2 - Murphy, Michael F. PY - 2012 T2 - Management of the Difficult and Failed Airway, 2e 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, for prolonged late decelerations. She weighs 253 lb (115 kg) and is 5 ft 3 in (160 cm) tall, giving her a BMI of approximately 45. Airway examination reveals a Mallampati Class III and a thyromental distance of 5 cm. She has a full neck extension with normal dentition and a normal mouth opening. 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 - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=55872584 ER -