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Pregnancy airway changes

Weight gain (12-20 kg)
  • Enlarging gravid uterus
  • Increasing total body water and interstitial fluid
  • Increasing blood volume
  • Deposition of new fat
  • Enlargement of the breasts
Respiratory system
  • Decrease in respirator reserve volume
  • Decrease in functional residual capacity (20%-30%)
  • Increased oxygen consumption
  • More rapid desaturation
Airway
  • Increased oral, nasal, pharyngeal, and tracheal mucosal edema
  • Vascular engorgement of oral, pharyngeal, and nasal capillaries
  • Edema of face and neck
  • Advancement of Mallampati classification with pregnancy
  • Advancement of Mallampati classification with bearing down during labor
Cardiovascular system
  • Inferior caval syndrome (supine hypotensive syndrome) requiring left uterine tilt
Gastrointestinal system
  • Steadily increasing intragastric pressure as pregnancy progresses
  • Decreased lower esophageal sphincter tone due to increasing progesterone
  • Symptomatic gastroesophageal reflux
  • Distortion of gastric anatomy
  • Increased gastric acidity
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