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Related Experiment Videos

Increase in Mallampati score during pregnancy

S Pilkington1, F Carli, M J Dakin

  • 1Division of Anaesthesia, Northwick Park Hospital and Clinical Research Centre, Harrow.

British Journal of Anaesthesia
|June 1, 1995
PubMed
Summary

A photographic Mallampati test showed a 34% increase in grade 4 cases in pregnant patients by 38 weeks gestation. This suggests pharyngeal edema impacts tracheal intubation difficulty in obstetrics, though not fully explaining reported failure rates.

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Area of Science:

  • Anesthesiology
  • Obstetrics
  • Airway Management

Background:

  • Difficult laryngoscopy is a concern in obstetric anesthesia.
  • The Mallampati test is used to predict airway difficulty.
  • Pregnancy-induced physiological changes may affect airway anatomy.

Purpose of the Study:

  • To evaluate changes in Mallampati scores during pregnancy.
  • To correlate Mallampati score changes with gestational age and weight gain.
  • To assess the impact of these changes on predicted airway difficulty in obstetrics.

Main Methods:

  • A photographic Mallampati test was developed.
  • 242 pregnant patients were assessed at 12 and 38 weeks gestation.
  • Mallampati scores were correlated with gestational age and weight gain.

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Main Results:

  • A 34% increase in Mallampati grade 4 cases was observed by 38 weeks gestation (P < 0.001).
  • The increase in Mallampati score correlated with body weight gain (r = 0.3, P < 0.001).
  • Difficult laryngoscopy rates in obstetrics (1.7%) were slightly higher than in general surgery (1.3%).

Conclusions:

  • Pharyngeal edema during pregnancy may contribute to tracheal intubation difficulty.
  • Weight gain and fluid retention are potential causes for increased Mallampati scores.
  • Further research is needed on factors affecting the Mallampati test, including neck extension, to rationalize difficult intubation management.