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Failed intubation at category 1 caesarean section — FRCA Final MCQ

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HardObstetric AnaesthesiaFailed intubation at category 1 caesarean sectionFRCA Final

A 29-year-old woman has a category 1 caesarean section under general anaesthesia for fetal bradycardia. Two intubation attempts fail; mask ventilation is adequate with SpO2 99%. A second-generation supraglottic airway is inserted and ventilation is effective. The baby remains severely bradycardic. What is the most appropriate management?

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Correct answer: C — Proceed with surgery using the supraglottic airway after declaring failed intubation

In obstetric failed intubation with effective oxygenation, the decision to wake or proceed depends on maternal oxygenation and urgency. In a category 1 caesarean with persistent fetal compromise, proceeding with a well-seated second-generation supraglottic airway may be appropriate after declaring failed intubation and calling for help. Repeated laryngoscopy increases harm. Front-of-neck airway is reserved for failure of oxygenation.

Reference: OAA/DAS obstetric failed intubation guideline 2015