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Orlando R. Hung, Michael F. Murphy+
TABLE 51–1.
Factors Affecting Management of the Parturient Airway
•Enlarging gravid uterus
•Increasing total body water and interstitial fluid
Weight gain (12–20 kg) •Increasing blood volume
•Deposition of new fat
•Enlargement of the breasts
•Decrease in respirator reserve volume
•Decrease in functional residual capacity (20%–30%)
Respiratory system
•Increased oxygen consumption
•More rapid desaturation
•Increased oral, nasal, pharyngeal, and tracheal mucosal edema
•Vascular engorgement of oral, pharyngeal, and nasal capillaries
Airway •Edema of face and neck
•Advancement of Mallampati classification with pregnancy
•Advancement of Mallampati classification with bearing down during labor
Cardiovascular system •Inferior caval syndrome (supine hypotensive syndrome) requiring left uterine tilt
•Steadily increasing intragastric pressure as pregnancy progresses
•Decreased lower esophageal sphincter tone due to increasing progesterone
Gastrointestinal system •Symptomatic gastroesophageal reflux
•Distortion of gastric anatomy
•Increased gastric acidity
Date of download: 09/27/20 from AccessAnesthesiology: accessanesthesiology.mhmedical.com, Copyright © McGraw Hill. All rights reserved.