Anaes · Airway management
The obstetric airway: failed intubation and the difficult airway in pregnancy
Also known as Obstetric airway · Obstetric difficult airway · Failed intubation in obstetrics · Obstetric general anaesthesia · Obstetric RSI · Can't intubate can't oxygenate in pregnancy
The obstetric airway combines the anatomical and physiological changes of pregnancy — mucosal oedema, friability, Mallampati deterioration, reduced functional residual capacity and a full stomach — with the pressure of two lives and an often-urgent indication. Failed intubation in obstetrics is rare but disproportionately lethal, and a rehearsed drill, a waking-up plan, and the right equipment on every obstetric general anaesthetic are the safeguards.
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8 MCQs with explanations
Target exams
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Meet the patient
A morbidly obese parturient at term is induced for an emergency caesarean under general anaesthesia. On the first laryngoscopy the view is poor and the breasts impede the handle; the saturation is already falling at sixty seconds. Two lives, two clocks — hers and the baby's — are now both running.[3]
This is the scenario every obstetric general anaesthetic is built to avoid, and the question that governs it is the one the drill turns on: when intubation fails, do I wake her up or do I proceed? Hold that decision, and the anatomy, the physiology and the equipment all fall into place around it.[2]
You have read the opening of this topic. The complete unit — every section and its primary-source references — is part of the Anaesthesia fellowship atlas.
References6Show ledgerHide ledger
- [1]Craig R, et al. Best practice in obstetric general anaesthesia: an umbrella review of pharmacological strategies for induction of general anaesthesia Anaesthesia, 2026.PMID 41987713
- [2]Ramkumar V, et al. All India Difficult Airway Association 2025 guidelines for the management of unanticipated difficult airway in obstetrics under general anaesthesia Indian J Anaesth, 2025.PMID 41293137
- [3]Saracoglu A, et al. Airway events in pregnant patients with morbid obesity undergoing caesarean delivery under general anaesthesia: a retrospective cohort study (2015-2024) Int J Obstet Anesth, 2026.PMID 41240486
- [4]Valentić IB, Reiner K Anaesthesia for Caesarean Section in a Parturient with Klippel-Feil Syndrome: A Case Report Turk J Anaesthesiol Reanim, 2026.PMID 42318747
- [5]Xiao Y, et al. Applications and prospects of ultrasound in difficult airway management: A narrative review Am J Otolaryngol, 2026.PMID 42248090
- [6]Mohamed IA, et al. Obstetric and Emergency Anesthesia in Somalia: Patient Safety Challenges in a Fragile Health System Int J Womens Health, 2026.PMID 42137251