Pregnancy Clinical Trial
Official title:
Incidence of Obstructive Sleep Apnea in Pregnancy
Obstructive sleep apnea is a condition characterized by obstruction of the upper airways and episodes of apnea and hypopnea during sleep. It is associated with significant adverse health effects. The incidence of obstructive sleep apnea in the general female population is approximately 2% but the incidence of obstructive sleep apnea in pregnancy is unknown. There is some evidence that pregnancy precipitates or at least exacerbates this condition and that there may be a relationship between intrauterine fetal growth retardation and maternal preeclampsia. In addition, there are several anesthetic implications that are concern for the patient with obstructive sleep apnea. These include: exquisite sensitivity to all central nervous system depressant drugs and the potential for upper airway obstruction or apnea with even minimal drug doses; difficult mask ventilation; difficult intubation; arterial hypoxemia; arterial hypercarbia; polycythemia; hypertension; pulmonary hypertension and cardiac failure. All of these conditions pose significant anesthetic risk for the patient, and this risk may be increased further by pregnancy.
All patients presenting to the Prentice Women's Hospital's (PWH) Labor and Delivery Unit for
spontaneous labor, induction of labor and scheduled cesarean delivery are routinely
interviewed by a member of the anesthesia team to obtain a detailed history and physical
examination and to discuss labor analgesia options. Immediately following this usual and
customary preanesthetic evaluation the member of the anesthesia team performing the
preanesthetic consultation (anesthesiology attending, resident physician, or nurse) used a
standard verbal consent script to obtain verbal consent from the subject for study
participation. Study participants were asked to complete a written validated survey, the
Berlin Questionnaire, evaluating self-reported snoring and daytime sleepiness as well as
basic demographic data (age, height, current weight and pregnancy weight gain). Survey
completion time was 1 to 2 minutes.
The survey was available in English and Spanish. It did not contain any subject personal
health information. The survey sheet remained in the labor and delivery room with the
subject's usual anesthesia medical record paperwork until the patient was discharged from
the unit. At the time of discharge, the infant's birthweight and APGAR scores were recorded
on the survey and the survey collected.
All female patients, ages 18 - 45, presenting to the PWH Operating Room for elective
gynecologic surgery, and all female patients, ages 18 - 45, presenting to the Northwestern
Memorial Hospital (NMH) Ambulatory Surgery Center were interviewed by a member of the
anesthesia team to obtain a routine preoperative history and physical examination and to
discuss the anesthesia options. Immediately following this usual and customary preanesthetic
evaluation the member of the anesthesia team performing the preanesthetic consultation
(anesthesiology attending, resident physician, or certified registered nurse anesthetist)
used a standard verbal consent script to obtain verbal consent from the subject for study
participation. Study participants were asked to complete a written validated survey, the
Berlin Questionnaire, evaluating self-reported snoring and daytime sleepiness as well as
basic demographic data (age, height, and weight). The survey was available in English and
Spanish. Survey completion time was 1-2 minutes. The survey did not contain any patient
identifying information and was collected after completion.
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