Airway events in pregnant patients with morbid obesity undergoing caesarean delivery under general anaesthesia: a retrospective cohort study (2015–2024)
Authors' conclusion
In conclusion, cardiovascular instability was the most common airway-related complication, difficult airway incidence increased with obesity class, and thyromental distance was the most consistent predictor
Study context
- Population
- Pregnant patients aged ≥ 18 years with BMI ≥ 40 kg/m² undergoing caesarean delivery under GA, January 2015–December 2024Class III 94.3%, Class IV/V 5.7%
- Participants
- 315 patients
- Exposure
- Obesity class III vs IV/V
- Outcome
- Frequency and types of airway complications during caesarean section under GA, stratified by obesity class
Methodological detailsData extracted from electronic medical records
- Data extracted from electronic medical records
Main finding
As reported in the abstract
Airway-related complications
Most common airway-related complication: cardiovascular instability
7.9%
Laryngospasm
1.6%
Observational data: associations, not effects.
Secondary outcomes
Thyromental distance as predictor of difficult mask ventilation
| OR (95% CI) | P value | ||
|---|---|---|---|
| Thyromental distance | 0.22 (0.11–0.44) | P < 0.001 | |
| 0.10.31310Odds ratio (log scale) |
- Thyromental distance as predictor of difficult mask ventilation: strongest predictive value; adjusted for age, BMI, and comorbidities
Thyromental distance and intubation attempts
- Inverse correlation, r
- −0.150
- P
- P = 0.008
BMI and peak airway pressure post-intubation
- Positive correlation
Safety
Perioperative complications
- Cardiovascular instability
- 7.9%
- Desaturation < 94% during intubation
- 1.0%
- Infrequent
Original publication
Airway events in pregnant patients with morbid obesity undergoing caesarean delivery under general anaesthesia: a retrospective cohort study (2015–2024). Int J Obstet Anesth. Published 8 November 2025. doi:10.
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