The increased edema and vascularity of respiratory mucosa associated with pregnancy may cause an increase in Mallampati score with progress of pregnancy, labour and delivery.
The study was conducted at VMMC &Safarjung Hospital, New Delhi, India, over a period of 18 months .Eighty parturients undergoing elective caesarean section and 80 parturients undergoing emergency caesaarean section were enrolled. Airway parameters like Modified Mallampati Test (MMT) and others were measured before caesarean section (T1) and 2 hrs (T2), 6hrs (T3) , 24 hrs (T4) ,48 hrs (T5) and72 hrs (T6) after delivery.
We observed that the mean MMPG at 2hours (T2), 6 hours (T3), 24 hours(T4) and 48 hours(T5) after delivery,was significantly higher in emergency group than that of elective group (p value=0.0001 ) .We observed that in both the study groups the maximum changes in MMPG occurred at 6hours after delivery. Normalization of MMPG to its pre- caesarean value occurred earlier with parturients not in active labour as compared to parturients with active labour .We observed that there was association between duration of labour and delay in normalization of changes occurring in MMPG from preoperative value (p value=0.023).
Airway changes in pregnant women are seen to worsen even after LSCS delivery of the foetus under spinal anaesthesia. Change in MMP grading post LSCS are affected adversely by prolonged labour. All parturients undergoing LSCS under spinal anaesthesia are at risk of airway compromise post-delivery &must be monitored for the same for at least 72 hours post LSCS.
Posted by: Dr.Nikki Sabharwal, PROFESSOR & CONSULTANT, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi 110029, India (24-Jan-2019)