Airway and Respiratory Challenges of Pregnancy

Mucosal edema associated with pregnancy puts the parturient at eight times greater risk of failed intubation over the general population. During pregnancy, the tidal volume increases to meet increased oxygenation demands of the parturient and the fetus. The minute ventilation also increases. The functional residual capacity decreases by as much as 20% due to the large expiratory volume. Several anatomical changes in the parturient including decreased esophageal sphincter tone, delayed gastric emptying, and increased gastric pressure increase the risk of aspiration of gastric contents (Mighty HE, Clin Obstet Gynecol. 53:360, 2010; Munnur U et al., Crit Care Med. 33:S259, 2005).