In pregnancy, which statements describe airway changes that can affect management?

• A. Pregnancy can improve airway patency and increase FRC.
• B. Pregnancy has no effect on airway management.
• C. Immediate intubation in all trimesters is always recommended.
• D. Pregnancy can cause airway edema, reduced functional residual capacity, and a higher risk of rapid desaturation; left lateral tilt is often used in pregnancy.

Answer: (D)

Pregnancy brings several airway and respiratory changes that directly affect how we manage the airway. Hormonal and hemodynamic shifts cause mucosal edema in the upper airway, which narrows the passage and makes tubes harder to place and airway patency more precarious. At the same time, the growing uterus elevates the diaphragm, reducing the functional residual capacity of the lungs. With the body’s oxygen demand increased during pregnancy, this reduced reserve means a patient will desaturate more quickly if breathing is interrupted or during induction. Because rapid desaturation is a real risk, thorough preoxygenation and preparedness for a potentially difficult airway are essential.

Left lateral tilt is commonly used in pregnancy because it relieves aortocaval compression by the uterus, improving venous return and overall oxygenation. This position also helps optimize maternal hemodynamics during airway management and anesthesia, which is why it’s often part of the management plan.

So, the statement that pregnancy can cause airway edema, reduced functional residual capacity, and a higher risk of rapid desaturation; with left lateral tilt often used in pregnancy, best describes how airway changes affect management.