Inhalation of Helium - Oxygen Mixture in Two Cases of Maternal Respiratory Distress during Labor and Delivery

Inhaled mixtures of helium - oxygen have been rarely used in spontaneously ventilating patients presenting with airway obstruction during labor and delivery. We present two patients, each suffering from severe tracheal narrowing due to extra - tracheal compression by goiter and each presenting with respiratory distress during the second stage of the labor. Inhaled helium/oxygen was administered to relieve respiratory distress; routine labor and assisted vaginal delivery ensued without furt her maternal or neonatal complication. We review the rationale for the use of inhaled helium/oxygen in such patients. We also review the anesthetic plan for unexpected abdominal delivery, including airway management for general anesthesia.