Difficult airway management in pregnancy

Difficult airway management during pregnancy is a life-threatening situation not only for the mother but also for the fetus. In the third trimester of pregnancy, the risk of difficult airway management is ten times higher compared to the non-pregnant population. Therefore, difficult airway management should be recognised in time, it’s important to proceed quickly and to achieve adequate ventilation, otherwise there are serious consequences such as hypoxic brain injury, fetal or maternal death. This algorithm will give you a chance to deal with two situations of difficult airway management. We use different muscle relaxants in each situation.

difficult airway management
Published at: 8.5.2020


Christian Kufa, MD
Chief of Obstetric Anaesthesiology, Department of Anaesthesiology and Intensive Care Medicine, University Hospital Ostrava and Faculty of Medicine, University of Ostrava, Czech Republic

The risk of difficult airway management is a cause for legitimate concern for any anesthesiologist. In the case of pregnancy, these concerns are doubled, as not only the life and health of the pregnant woman is in danger but also the fetus` ones is. Therefore it is more than appropriate that any anesthesiologist should routinely and reliably perform urgent airway management in pregnancy. This algorithm offers us a real situation where it is necessary to act correctly and quickly to ensure maximal safety during airway management of a pregnant patient undergoing acute or urgent surgery. The algorithm guides us through a point by point decision-making process for a certain patient and, in a well-arranged and simple form, allows us to repeat and check the correctness of the basic procedures that we use in everyday practice.


HENLÍN, Tomáš. Obtížné zajištění dýchacích cest u dospělých a u dětí; nový doporučený postup ČSARIM. Anesteziologie a intenzivní medicína [online]. 2019, 30(3-4), 115 [cit. 2020-03-22]. ISSN 1214-2158. Available at: https://www.prolekare.cz/casopisy/anesteziologie-intenzivni-medicina/2019-3-4-2/obtizne-zajisteni-dychacich-cest-u-dospelych-a-u-deti-novy-doporuceny-postup-csarim-118452

ADAMUS, Milan. Monitorování svalové relaxace. Anesteziologie & intenzivní medicína [online]. 2012, 23(3), 156-162 [cit. 2020-03-22]. ISSN 1214-2158. Available at: http://www.prolekare.cz/anesteziologie-intenzivni-medicina-archiv-cisel

PAŘÍZEK, Antonín. Analgezie a anestezie v porodnictví. 2., rozš. a přeprac. vyd. Praha: Galén, c2012. ISBN 978-80-7262-893-3.

Related algorithms