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Modified Mallampati Class Rating Before and After Cesarean Delivery: A Prospective Observational Study
Lisa Sangkum1, Worapot Apinyachon1, Benno von Bormann2
1Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Asian Journal of Anesthesiology
|May 5, 2021
Summary
Cesarean delivery significantly increases the modified Mallampati classification (MMC), indicating a higher risk of difficult laryngoscopy in pregnant women. This airway anatomy change is noted post-delivery, highlighting a specific risk for cesarean patients.
Area of Science:
- Anesthesiology
- Obstetrics
Background:
- The modified Mallampati classification (MMC) assesses tongue size relative to oral cavity, predicting difficult laryngoscopy.
- Previous research suggests MMC increases during pregnancy, but studies in cesarean delivery patients are limited.
Purpose of the Study:
- To evaluate changes in MMC before and after cesarean delivery.
- To assess the airway anatomy risk in women undergoing cesarean delivery.
Main Methods:
- A prospective observational study involving 104 women undergoing cesarean section.
- MMC, thyromental distance, neck circumference, and upper lip bite test were measured at four time points: pre-anesthesia and 1, 6, and 24 hours post-delivery.
- Logistic regression analyzed correlations between MMC changes and factors like weight gain, operation time, fluid administration, oxytocin dosage, and blood loss.
Main Results:
- 59.6% of participants experienced changes in their Mallampati classification.
- Mallampati classes III and IV increased significantly post-delivery, from 48.1% pre-delivery to 84.6% at 24 hours post-delivery.
- No correlation was found between MMC changes and gestational weight gain, surgery duration, anesthetic method, blood loss, oxytocin, or fluid volume.
Conclusions:
- A high prevalence of initial Mallampati III was observed.
- Cesarean delivery leads to a significant increase in MMC, confirming altered airway anatomy.
- Women undergoing cesarean delivery face a specific risk related to airway anatomy changes post-procedure.
