• Junko Ushiroda, Satoki Inoue, Junji Egawa, Yasunobu Kawano, Masahiko Kawaguchi, and Hitoshi Furuya.
• Department of Anesthesiology, Nara Medical University, Kashihara, Japan.
• Braz J Anesthesiol. 2013 Nov 1;63(6):508-10.

Background And ObjectivesAirway changes generally occur in normal gravidas; however, these changes could cause critical situations in specific populations.ObjectivesThis article presents the case of a difficult airway patient that went into shock because of atonic bleeding after vaginal delivery for stillbirth.Case ReportA 32-yr-old woman with atonic bleeding after vaginal delivery for stillbirth was transferred to our hospital. She manifested shock, and her respiratory condition was progressively deteriorating. Airway obstruction caused by neck swelling and pharyngolaryngeal edema was apparent. We tried tracheal intubation using direct and indirect laryngoscopes. However, it turned out that insertion of the laryngoscopic devices to the oral cavity was impossible. After several attempts using the Trachlight™, successful intubation was finally made. After hysterectomy, she was admitted to the intensive care unit (ICU) and treated for five days. At discharge from the ICU, her Mallampati score was I-II. Her body weight decreased 60 kg to 51 kg during ICU stay.ConclusionsWe believe that concomitant attacks of labor and delivery and fluid resuscitation probably worsened upper airway and neck edema enough to cause acute airway obstruction and difficult laryngoscopy.Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

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