Raza D, Ismail S
Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan.
Acta Anaesthesiol Scand. 2018 Sep;62(8):1086-1091. doi: 10.1111/aas.13153. Epub 2018 May 22.
Mallampati class has been shown to increase during labor. There are no prospective studies evaluating airway changes in hypertensive parturients during labor. The aim of our study was to observe the frequency of change in Mallampati class during labor in hypertensive compared to normotensive parturients.
In this prospective observational cohort study, 60 parturients were enrolled and divided into two groups of 30 each: hypertensive parturients and normotensive parturients. The Mallampati class was evaluated in each parturient at two points; during early labor (cervical dilation 1-3 cm and regular contractions) taken as T1 and at 20 minutes after delivery taken as T2. The change in Mallampati class from T1 to T2 was compared between the two groups. Post-stratification chi-square test was applied and P value <.05 was considered as significant.
The change in Mallampati class was significantly more frequent in hypertensive group as compared to normotensive group [80% (24/30) vs 46.7% (14/30); P = .002]. Overall, an increase in Mallampati class during labor was found with statistically significant difference between the hypertensive and normotensive group [80% (24/30) vs 42.9% (12/28); P = .004]. The risk of increase in Mallampati class was 2 times higher in hypertensive women as compared to normotensive 2.44; 95% CI: 1.19 to 5.02].
Mallampati class showed 2-fold increase in hypertensive compared to normotensive parturients during labor; requiring additional caution during airway management.
已证明马兰帕蒂分级在分娩过程中会升高。目前尚无前瞻性研究评估高血压产妇分娩期间气道的变化。我们研究的目的是观察高血压产妇与血压正常产妇在分娩期间马兰帕蒂分级变化的频率。
在这项前瞻性观察性队列研究中,招募了60名产妇,分为两组,每组30名:高血压产妇和血压正常产妇。在两个时间点对每位产妇的马兰帕蒂分级进行评估;分娩早期(宫颈扩张1 - 3厘米且有规律宫缩)作为T1,分娩后20分钟作为T2。比较两组从T1到T2的马兰帕蒂分级变化。应用分层后卡方检验,P值<0.05被认为具有统计学意义。
与血压正常组相比,高血压组马兰帕蒂分级的变化明显更频繁[80%(24/30)对46.7%(14/30);P = 0.002]。总体而言,分娩期间发现马兰帕蒂分级升高,高血压组和血压正常组之间存在统计学显著差异[80%(24/30)对42.9%(12/28);P = 0.004]。高血压女性马兰帕蒂分级升高的风险是血压正常女性的2倍[比值比2.44;95%置信区间:1.19至5.02]。
与血压正常的产妇相比,高血压产妇在分娩期间马兰帕蒂分级升高了2倍;在气道管理期间需要格外谨慎。