Recognising obstructive sleep apnoea in pregnancy – a survey of <scp>UK</scp> obstetric anaesthetists

Miskovic, Alice; Simpson, Mark P.; Dominguez, Jennifer E.; Bullough, Alexandra S.

doi:10.1111/anae.14151

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…STOP-BANG was the most commonly used screening tool among the departments that screened for OSA. 9 Similar studies with the use of STOPBANG in the first and third trimesters of pregnancy concluded that even though it had a good negative predictive value, the score was not useful for detecting OSA. [9][10][11][12][13] Tantrakul et al 14 studied the usage of STOPBANG questionnaire in 72 women across trimesters and found it to have the best predictive value during the second trimester.…”

Section: Discussionmentioning

confidence: 92%

Study on assessment of Obstructive sleep apnea (OSA) risk in Obese pregnant women

Durga¹,

Yuvarajan²,

Radhakrishnan³

et al. 2020

IJIRM

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Obstructive sleep apnea is a major public health concern which is associated with cardiovascular and cerebrovascular comorbidities. Eventhough association of OSA with adverse fetomaternal outcomes is documented, screening for OSA in pregnancy is a challenging task. So the purpose of our study is to assess the risk of OSA in obese pregnant ladies by using established STOP BANG Questionnare for OSA. Materials and Methods: This cross sectional study on assessment of obstructive sleep apnea risk among the obese pregnant women was done in tertiary care centre in the rural population of Puducherry. Results: 21 obese pregnant women were included in our study. The mean age of our study population was 29.5 years. Most of the study subjects (85.7%) had history of snoring both reported by them and their bed partners. History of tiredness was reported by 14 patients (66.6%).Chocking or history of gasping was reported by only 4 patients (19%). Results of our study showed that 42.9% of the obese pregnant women had high risk, 42.9% had intermediate risk and 14.3% for OSA as per the STOP BANG scoring. Conclusion: Thus our study subjects were having higher risk of OSA which needed further evaluation with polysomnography. Thus the STOPBANG questionnaire can be used to screen for obstructive sleep apnea (OSA) in obese women during pregnancy.

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Section: Discussionmentioning

confidence: 92%

Study on assessment of Obstructive sleep apnea (OSA) risk in Obese pregnant women

Durga¹,

Yuvarajan²,

Radhakrishnan³

et al. 2020

IJIRM

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“…Part of the reason for underdiagnosis is the apparent lack of a coherent approach to screening or diagnosis of SDBP. Questionnaire surveys of obstetric anaesthetists in North America [45] and the UK [46] revealed that most facilities do not have SDBP management guidelines, and many never screen for SDBP even when patients are deemed “high-risk”. When screening does take place, the surveys indicate that the most common methods were ESS, BQ and STOP-Bang questionnaires, which as discussed have limited utility in this group.…”

Section: Underdiagnosismentioning

confidence: 99%

Pregnant pause: should we screen for sleep disordered breathing in pregnancy?

Perkins

Einion

2019

Breathe

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Physiological and hormonal changes in pregnancy can contribute towards sleep disordered breathing in pregnant women (SDBP). When present, SDBP increases the risk of several adverse maternal and fetal outcomes independent of factors such as age, weight and pre-existing maternal comorbidities. SDBP is underdiagnosed and may be hard to recognise because the presentation can be difficult to differentiate from normal pregnancy and the severity may change over the course of gestation. Timely intervention seems likely to help reduce adverse outcomes, but the relative benefits of intervention are still unclear. The definition of what constitutes a sleep-related breathing “disorder” in pregnancy may be different to the general population and so traditional thresholds for intervention may not be relevant in pregnancy. Any modifications to the disease definition in this group, or implementation of more intensive screening, may result in overdiagnosis. Further research is needed to help clinicians evaluate the balance of benefits and harms in this process. Until this is clearer there is a strong imperative for shared decision making in screening and treatment decisions, and screening programmes should be monitored to assess whether improved outcomes can be achieved at the healthcare system level.Key pointsUntreated sleep disordered breathing in pregnancy poses risks to maternal and fetal wellbeing, but it is underdiagnosed.Careful approaches to screening could improve rates of diagnosis, but thresholds for and benefits of intervention are unclear.Clinical guidelines and screening programmes for sleep disordered breathing in pregnancy need to consider the potential harms of overdiagnosis and should involve shared decision making and careful monitoring of outcomes relevant to the individual.Educational aimsExplore current knowledge of the prevalence of sleep disordered breathing in the pregnant population.Explore the relationship between sleep disordered breathing and adverse outcomes.Understand the approaches to diagnosis and management of sleep disordered breathing in pregnancy.Explore issues around screening, underdiagnosis and overdiagnosis in the context of sleep disordered breathing in pregnancy.

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