Mallampati class changes during pregnancy, labour, and after delivery: can these be predicted?

Area of Science:

• Anesthesiology
• Obstetrics
• Airway Management

Background:

• Elevated Mallampati class correlates with challenging laryngoscopy in obstetric anesthesia.
• Understanding Mallampati class evolution during and after labor is crucial for patient safety.

Purpose of the Study:

• To assess changes in Mallampati class before, during, and after labor.
• To identify factors predicting these Mallampati class alterations.

Main Methods:

• Mallampati class was assessed in 87 pregnant patients at four intervals: pre-labor, during epidural placement, and at 20 minutes and 48 hours postpartum.
• Evaluated factors included gestational weight gain, labor duration, and IV fluid administration.
• Logistic regression analyzed associations between factors and Mallampati class changes.

Main Results:

• Mallampati class remained unchanged in 37% of patients.
• The incidence of Mallampati classes 3 and 4 significantly increased from 10.3% pre-labor to a peak of 51.7% immediately postpartum (P<0.01).
• No evaluated factors predicted Mallampati class evolution.

Conclusions:

• Mallampati class significantly increases during labor and does not fully normalize by 48 hours postpartum.
• Airway assessment prior to anesthetic management in obstetric patients is essential.
• These findings underscore the dynamic nature of airway evaluation in pregnancy.