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Chapter 26 - Neurological disease and neurological catastrophes
from Section 4 - The pregnant patient with coexisting disease
- By Cynthia A. Wong, Roland Devlieger
Edited by Marc van de Velde, Helen Scholefield, Lauren A. Plante
Book:

Maternal Critical Care

Published online:

05 July 2013

Print publication:

04 July 2013, pp 285-300
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Summary

The problems in the pregnant woman are universal: physiological changes during pregnancy lead to a reduction in time from onset of apnea to oxygen desaturation and to an increased likelihood of regurgitation from a full stomach. An antenatal visit allows the airway to be evaluated and discussion to be held with the parturient about the use of invasive monitors, such as invasive arterial blood pressure monitoring and the use of continuous positive airway pressure devices during and after labor and delivery. A recent development in the management of the airway in the obese patient is the use of the so-called ramped position. Perhaps the main factor responsible for a higher incidence of difficulties in airway management is that general anesthesia is generally reserved for extreme obstetric emergencies. The use of supraglottic airways in the management of the obstetric airway is undergoing evaluation.