INCREASE IN MALLAMPATI SCORE DURING PREGNANCY

A photographic version of the Mallampati test was developed and applie d to 242 pregnant patients at 12 weeks' gestation and again at 38 week s' gestation. At 38 weeks the number of grade 4 cases had increased by 34% (P < 0.001). This is in agreement with other evidence which sugge sts that difficult laryngoscopy is slightly more frequent in obstetric s (1.7%) than in general surgery (1.3%). The increase in Mallampati sc ore correlated with gain in body weight (r = 0.3, P < 0.001), which gi ves some support to the concept that fluid retention is the underlying cause. We conclude that pharyngeal oedema causes some hindrance to tr acheal intubation in obstetrics, but not enough to explain the high fa ilure rate reported. A case is made for rationalizing the management o f difficult intubation. Our data also show that more research is neede d on factors which affect Mallampati's test, particularly neck extensi on.