Respiratory and Airway Considerations in Obstetric Patients
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Purpose of Review
The purpose of this article is to provide the current evidences on respiratory and airway medicine in the obstetric population.
The prevalence of obstructive sleep apnea (OSA) among pregnant women is increasing. Upper body elevation improves respiratory mechanics in parturients and reduces the risk of postpartum OSA. Clinically significant respiratory depression from neuraxial opioid administration, compared to parenteral, is extremely rare.
The incidence of failed tracheal intubation in obstetric patients is higher than that in non-obstetric patients and it has been unchanged recently. The first obstetric-specific guidelines for the management of difficult airway were published in 2015.
The incidence of serious aspiration in obstetric patients is low and has been decreasing. Interventions to reduce aspiration at cesarean delivery recommended by recently published guidelines and clinical studies will be discussed. Supplemental oxygen during uncomplicated delivery, either cesarean or vaginal, has been controversial.
Understanding the changes in airway anatomy and respiratory physiology related to pregnancy, and adherence to evidence-based guidelines are essential in taking care of obstetric patients. Recently published scholarly articles and clinical guidelines relevant to respiratory physiology and airway management in obstetric anesthesia will be presented.
KeywordsAirway changes in pregnancy OSA in pregnancy Obstetric airway management Obstetric general anesthesia Aspiration in pregnancy Supplemental oxygen for parturients
Compliance with Ethical Standards
Conflict of Interest
Ayumi Maeda, Nobuko Fujita, and Yasuko Nagasaka declare they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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