{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T23:14:52Z","timestamp":1793661292133,"version":"4.5.1"},"reference-count":123,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>\n                    Central neuraxial anaesthesia is the preferred approach for caesarean deliveries leading to less frequent use of general anaesthesia. The 2025 guidelines for managing general anaesthesia in obstetrics recommend rapid sequence induction and intubation for parturients requiring general anaesthesia for caesarean delivery. If the initial intubation attempt fails, the team should\n                    <jats:italic toggle=\"yes\">\u201cCall for help for difficult airway\u201d<\/jats:italic>\n                    (Code D) and prioritise oxygenation (SpO\n                    <jats:sub>2<\/jats:sub>\n                    &gt; 95%). Tracheal intubation may be attempted by a more experienced operator after re-optimising position and considering alternate airway devices. The primary anaesthesia team can opt for a 2\n                    <jats:sup>nd<\/jats:sup>\n                    generation supraglottic airway (SGA) device as a rescue device or continue the anaesthetic using a face mask (FM). Maintaining oxygenation is critical. If satisfactory oxygenation is achieved with 2\n                    <jats:sup>nd<\/jats:sup>\n                    generation SGA or FM, the decision to continue will depend upon maternal and fetal condition. If satisfactory ventilation cannot be maintained with 2\n                    <jats:sup>nd<\/jats:sup>\n                    generation SGA or FM following failed tracheal intubation, the team declares \u201ccomplete ventilation failure\u201d and proceeds to surgical cricothyroidotomy. Should maternal cardiac arrest occur, proceed to \u201cresuscitative hysterotomy\u201d to improve chances of saving mother and baby. Post-resuscitation care should continue in the ICU to return the parturient to normalcy. Parturients may have a physiologically difficult airway in addition to anatomical reasons for airway difficulty. Specific steps to deal with associated pathophysiological changes constitute an important aspect of airway management in obstetrics. If a difficult airway is encountered, an \u201cAirway Alert Card\u201d must be given to the parturient and her responsible relatives to avoid similar life-threatening situations in future.\n                  <\/jats:p>","DOI":"10.4103\/ija.ija_1082_25","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T19:01:27Z","timestamp":1761937287000},"page":"1142-1166","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["All India Difficult Airway Association 2025 guidelines for the management of unanticipated difficult airway in obstetrics under general anaesthesia"],"prefix":"10.4103","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3450-2135","authenticated-orcid":false,"given":"Venkateswaran","family":"Ramkumar","sequence":"first","affiliation":[{"name":"Former Professor and Head, Department of Anaesthesiology, Kasturba Medical College, Manipal, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3077-8326","authenticated-orcid":false,"given":"Kajal","family":"Jain","sequence":"additional","affiliation":[{"name":"Professor and Head, Department of Anesthesia and Intensive Care, PGIMER, Chandigarh, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9324-4108","authenticated-orcid":false,"given":"Amit P.","family":"Shah","sequence":"additional","affiliation":[{"name":"Consultant Anaesthesiologist, Department of Anaesthesia, Isha Multispeciality Hospital, Vadodara, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6749-7221","authenticated-orcid":false,"given":"Sumalatha R.","family":"Shetty","sequence":"additional","affiliation":[{"name":"Professor, Medical Superintendent, Department of Anaesthesiology and Critical Care, Justice K S Hegde Charitable Hospital, K S Hegde Medical Academy, NITTE (Deemed to be University), Deralakatte, Mangaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6999-0730","authenticated-orcid":false,"given":"M. Govindraj","family":"Bhat","sequence":"additional","affiliation":[{"name":"Associate Professor, Department of Anaesthesiology and Critical Care, K S Hegde Medical Academy NITTE (Deemed to be University), Deralakatte, Mangaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1280-5047","authenticated-orcid":false,"given":"Aruna","family":"Parameswari","sequence":"additional","affiliation":[{"name":"Professor and Head, Department of Anesthesiology and Pain Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1788-540X","authenticated-orcid":false,"given":"Syed Moied","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Vice Chancellor, Al-Karim University, Katihar, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2836-7301","authenticated-orcid":false,"given":"Anju","family":"Grewal","sequence":"additional","affiliation":[{"name":"Professor and Head, Department of Anaesthesiology, All India Institute of Medical Sciences, Bathinda, Punjab, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6761-163X","authenticated-orcid":false,"given":"Sheila Nainan","family":"Myatra","sequence":"additional","affiliation":[{"name":"Professor, Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5842-8024","authenticated-orcid":false,"given":"Rakesh","family":"Garg","sequence":"additional","affiliation":[{"name":"Professor, Department of Onco-Anaesthesiology and Palliative Medicine, Dr BRAIRCH and National Cancer Institute, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1452-9282","authenticated-orcid":false,"given":"Jeson R.","family":"Doctor","sequence":"additional","affiliation":[{"name":"Professor, Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7384-4886","authenticated-orcid":false,"given":"Jigeeshu V.","family":"Divatia","sequence":"additional","affiliation":[{"name":"Head, Critical Care Medicine, Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6210-038X","authenticated-orcid":false,"given":"Sabyasachi","family":"Das","sequence":"additional","affiliation":[{"name":"Former Professor, Department of Anaesthesia, Deben Mahata Government Medical College and Hospital, Purulia, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5670-7932","authenticated-orcid":false,"given":"Pankaj","family":"Kundra","sequence":"additional","affiliation":[{"name":"Professor, Department of Anaesthesiology and Critical Care, JIPMER, Pondicherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,31]]},"reference":[{"key":"R1-20260419","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1097\/AOG.0b013e31820093a9","article-title":"Anaesthesia-related maternal mortality in the United States: 1979\u20132002","volume":"117","author":"Hawkins","year":"2011","journal-title":"Obstet Gynecol"},{"key":"R2-20260419","first-page":"1","article-title":"Saving mothers\u2019 lives: Reviewing maternal deaths to make motherhood safer 2006-2008. 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