Anesthetic and obstetric outcomes in pregnant women undergoing cesarean delivery according to body mass index: Retrospective analysis of a single-center experience

Abstract

AimTo evaluate maternal, neonatal and anesthetic outcomes according to BMI in women undergoing cesarean section.BackgroundIncreased incidence rates of obesity and morbid obesity have been reported in the United States. Pregnant obese patients are at increased risk of maternal and fetal complications, and obstetric and anesthetic management of these patients is especially challenging.MethodsA retrospective chart review of patients who underwent cesarean section in a single center between 2015 and 2016 was conducted. Anesthetic, obstetric and neonatal outcomes were analyzed in relation to levels of BMI.ResultsSeven hundred and seventy one patients underwent cesarean section during the study period. The number of patients with normal BMI, obesity and morbid obesity was 213 (27.6%), 365 (47.3%) and 193 (25%), respectively. Sixty-one percent of the patients in morbidly obese group had at least one comorbidity (p < 0.01). We found no significant differences with respect to perioperative obstetric complications. Intraoperative blood loss was significantly higher in the morbidly obese group.ConclusionIncreasing BMI is associated with comorbidities such as hypertension and diabetes mellitus, and with increased intraoperative blood loss. We were unable to detect differences in other obstetric, anesthetic and neonatal outcomes.

Comparison of perioperative outcomes and anesthetic-related complications of morbidly obese and super-obese parturients delivering by cesarean section

“…However, only a tiny proportion of the parturients who had a cesarean delivery at our institute were morbidly obese (BMI ≥ 40 kg/m 2 ): 2.2% (∼500 patients in 22,191 cesarean deliveries). In contrast, data from the United States showed a high prevalence of mothers with morbid obesity (12–25%) [ 15 , 18 ]. However, our prevalence was consistent with the rates reported for the United Kingdom by the Centre for Maternal and Child Enquiries in 2010.…”

The measurement of skin to epiglottis length for difficult airway prediction by ultrasonography in obese pregnant women: Prospective cohort study

“…Radyoloji kliniğine gebelikle ilgili rutin USG kontrolü için başvuran gebelere birinci ve üçüncü trimesterde eş zamanlı olarak boyun USG yapılarak cilt-epiglot mesafesi ölçülmüştür. 1. trimester ölçümler 'a', 3. trimester ölçümler 'b' harfi ile isimlendirilmiştir.…”

“…The dramatically increasing rate of obesity in the general population also extends to women of reproductive age. The anesthesiologist must be prepared to customize a perioperative plan to take care of these patients in the operating rooms [3]. Obesity increases the risk for cesarean delivery significantly and anesthesiologists are increasingly faced with morbidly obese patients.…”

Epidural analgesia in the obese obstetric patient: a retrospective and comparative study with non-obese patients at a tertiary hospital

“…1 BMI has in fact increased up to 0.4% during the last 30 years worldwide. 2 Overweight and obese patients are associated with greater comorbidity, such as coronary diseases, hypertension, obstructive sleep apnea, or gastrointestinal reflux. 2 …”