• M Godley and A R Reddy.
• Department of Anaesthesia, University of British Columbia, B.C. Women's Hospital and Health Centre Society, Vancouver.
• Can J Anaesth. 1996 Mar 1; 43 (3): 299-302.

PurposeThis case report describes the use of a Laryngeal Mask Airway in a morbidly obese parturient with the H.E.L.L.P. syndrome. An urgent Caesarean section was required because of vaginal bleeding and fetal distress.Clinical FeaturesThe patient was a 32 year old G3, T1, P1, L1 who presented with epigastric pain, headache, vomiting, and diarrhoea. She was hypertensive (180/110 mmHg) and thrombocytopaenic (18 x 10(-9). L-1). Examination of the airway revealed a short neck, receded jaw, full dentition, large breasts and she was considered to be a potential intubation problem. The patient required an awake intubation using a technique that minimized hypertension, aspiration risk, airway trauma, and hypoxia. A laryngeal mask was used to facilitate tracheal intubation, and the patient tolerated the procedure with no adverse outcome.ConclusionThe LMA has a place to facilitate potentially difficult awake tracheal intubation with the pregnant patient.

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