Difficult Airway: Special Considerations in Pregnancy

Pregnant patients are at increased risk of difficult airway management due to both anatomic and physiologic changes that occur with pregnancy and during the process of labor. While the majority of surgical procedures on labor and delivery are performed with neuraxial anesthesia, general anesthesia may be required at any time. As such, all anesthesia professionals must be prepared at all times for unplanned and emergent obstetric airway management, including management of the difficult airway in the parturient. Strategies include assessment of patient risk early in labor, maintaining difficult airway equipment in the labor and delivery suites, conducting simulation scenarios of difficult and failed airway management, and following difficult airway management algorithms.