Service d'Anesthésie, Hôpital Louis Mourier, 178 rue des Renouillers, F-92701 Colombes, France.
Br J Anaesth. 2010 Jan;104(1):67-70. doi: 10.1093/bja/aep356.
An increase in Mallampati class is associated with difficult laryngoscopy in obstetrics. The goal of our study was to determine the changes in Mallampati class before, during, and after labour, and to identify predictive factors of the changes.
Mallampati class was evaluated at four time intervals in 87 pregnant patients: during the 8th month of pregnancy (T(1)), placement of epidural catheter (T(2)), 20 min after delivery (T(3)), and 48 h after delivery (T(4)). Factors such as gestational weight gain, duration of first and second stages of labour, and i.v. fluids administered during labour were evaluated for their predictive value. Mallampati classes 3 and 4 were compared for each time interval. Logistic regression was used to test the association between each factor and Mallampati class evolution.
Mallampati class did not change for 37% of patients. The proportion of patients falling into Mallampati classes 3 and 4 at the various times of assessment were: T(1), 10.3%; T(2), 36.8%; T(3), 51.7%; and T(4), 20.7%. The differences in percentages were all significant (P<0.01). None of the evaluated factors was predictive.
The incidence of Mallampati classes 3 and 4 increases during labour compared with the pre-labour period, and these changes are not fully reversed by 48 h after delivery. This work confirms the absolute necessity of examining the airway before anaesthetic management in obstetric patients.
Mallampati 分级增加与产科困难喉镜检查有关。我们的研究目的是确定分娩前后 Mallampati 分级的变化，并确定变化的预测因素。
在 87 名孕妇的四个时间间隔评估 Mallampati 分级：妊娠 8 个月（T(1)）、放置硬膜外导管时（T(2)）、分娩后 20 分钟（T(3)）和分娩后 48 小时（T(4)）。评估了妊娠体重增加、第一产程和第二产程的持续时间以及分娩期间给予的静脉输液等因素对预测值的影响。比较了每个时间间隔的 Mallampati 分级 3 和 4。使用逻辑回归检验每个因素与 Mallampati 分级变化之间的关联。
37%的患者 Mallampati 分级没有变化。在评估的各个时间点，Mallampati 分级为 3 和 4 的患者比例分别为：T(1)，10.3%；T(2)，36.8%；T(3)，51.7%；T(4)，20.7%。百分比差异均有统计学意义（P<0.01）。未评估的因素均无预测性。
与产前相比，分娩期间 Mallampati 分级 3 和 4 的发生率增加，并且这些变化在分娩后 48 小时内并未完全逆转。这项工作证实了在产科患者进行麻醉管理之前检查气道的绝对必要性。
