A comparison of upper airway parameters in postpartum patients: vaginal delivery vs. caesarean section

Abstract

Mallampati class has been shown to increase during labour. The influence of delivery mode on this change is not known yet. The aim of our study is to investigate the changes of upper airway parameters in parturients after caesarean section and vaginal delivery. Ninety parturients undergoing elective caesarean section and ninety parturients with vaginal delivery were enrolled. The parameters of Modified Mallampati test (MMT), inter-incisor distance, thyromental distance, sternomental distance, neck circumference were measured before labour (T0) and 1 h (T1), 6 h (T6) and 24 h (T24) after delivery. Overall, 39 parturients (45.3%) with increases in MMT class in the vaginal delivery group within 24 h After childbirth, were more than that in the caesarean section group [24 parturients (26.7%), P=0.01]. In the vaginal delivery group, the incidence of the increases in MMT class at T1 and T6 were similar, which were higher than that at T24 (P=0.015). In the caesarean section group, the incidence of MMT class increases at T6 was significantly higher than that at T1 (P=0.015) and T24 (P=0.015). Our findings indicate that increase in Mallamapti class may be more significant and may take place earlier in parturients undergoing vaginal delivery than in those undergoing elective caesarean section.

Keywords: Airway; Modified Mallampati test; anesthesia; labour; obstetric.

Figure 1

CONSORT flow diagram. Ninety parturients undergoing elective caesarean section (caesarean section group) and ninety parturients with vaginal delivery (vaginal delivery group) were enrolled. Four parturients from vaginal delivery group were excluded due to emergency transference to caesarean.

Figure 2

MMT classes at different time points in caesarean section group (A) and vaginal delivery group (B). In caesarean section group, the MMT classes at T1 and T6 were significantly higher than that at T0 (P < 0.05), while the MMT class at T24 was not significantly different from that at T0 time point. In vaginal delivery group, the MMT class at T1 was significantly higher than that at T0 (P < 0.05), while the MMT classes at T6 and T24 were not significantly different from that at T0.