Airway challenges in pregnancy
Pregnancy carries an eightfold increased risk of failed intubation(17). The main reason is the increased vascularity and edema of the respiratory mucosa(18). Therefore, a smaller size endotracheal tube should be used. In addition, due to increased O2consumption in pregnancy and decreased oxygen reserve, a more precipitous drop in PaO2 is anticipated during intubation(18). Optimal pre-oxygenation without hyperventilation will minimize the magnitude of desaturation. An obstetrically trained anesthesiologist should perform the intubation. It is the standard practice at our institution that they are present for non-emergent intubations outside the obstetrical care unit. The availability of an obstetrically trained anesthesiologist offers the necessary support for airway management during proning, eliminating the hesitation to prone a pregnant patient.