Change in Mallampati Score during Pregnancy, Labour and Post Labour: An Observational Study

Abstract

Background Mallampati (MP) score is used to predict the ease of endotracheal intubation. Pregnancy is often associated with failed intubation during anaesthesia for caesarean delivery and contributes majorly to maternal complications that are related to anaesthesia. This study aimed to determine the change in MP grade over the course of pregnancy (first trimester, during labour and post-delivery). Methods The study was conducted on 389 pregnant women in the first trimester. Demographic data, airway characteristics and MP score of the patients were recorded at different stages of pregnancy. Change in MP grade was assessed for those patients, who have delivered vaginally. Results The mean age of the study subjects was 25.77±3.64 years. There was a significant association of MP score with weight gain (P<0.0001) and change in neck circumference (P<0.0001). There was a significant change in the number of patients with MP grade 3 and 4 was noted from first trimester (n=14; 2.26%) to 48 hours post-delivery (n=78; 24.6%) (P<0.01), showing a strong association between change in MP score and pregnancy. Conclusion There was a significant increase in the MP score over the course of pregnancy that may be attributed to gestational weight gain along with variations in the neck circumference in pregnant women. Hence, assessment of MP score is important for proper management of difficult intubation, especially in parturient.