RT Book, Section
A1 Olufolabi, Adeyemi J.
A1 Muir, Holly A.
A2 Hung, Orlando
A2 Murphy, Michael F.
SR Print(0)
ID 55872584
T1 Chapter 51. Unanticipated Difficult Airway in an Obstetrical Patient Requiring an Emergency Cesarean Section
T2 Management of the Difficult and Failed Airway, 2e
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-162344-5
LK accessanesthesiology.mhmedical.com/content.aspx?aid=55872584
RD 2024/04/18
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.