Anesthesia Complications During Scheduled Cesarean Delivery for Morbidly Obese Women

Vricella, Laura K.; Louis, Judette; Mercer, Brian M.; Bolden, Norman

doi:10.1097/ogx.0b013e3182021fa8

Cited by 12 publications

(12 citation statements)

References 24 publications

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“…We could not define the frequency of Caesarean among the obese parturient in relation to the non-obese parturient. The obesity at the parturient is associated to affections as: the arterial hypertension, the diabetes, the asthma, the pre-eclampsia and the OSAS [10]. In our survey this association was meaningful for the arterial hypertension, the nocturnal burrs and the OSAS.…”

Section: Discussionsupporting

confidence: 55%

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Complications of Obesity in Cesarized Parturients in the Teaching Centers of Cotonou

Hodé¹,

Zoumenou²,

Hounkpatin³

et al. 2018

OJEMD

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This survey had the objective to determine the frequency of the obesity at the parturient, to value the impact of the obesity on the childbirth by Caesarean and the complications postoperative immediate in the teaching hospitals of Cotonou. Patients and Method: We did a prospective, comparative and analytic survey from January 13 to April 13, 2012. Eight hundred ninety-one consecutive parturients having had a Caesarean were included. We studied the anesthetic techniques, the techniques of control of the aerial ways, the number of necessary tests for the tracheal intubation, the complications and aftercare of the first 48 hours. A comparison has been made according to the BMI. The obesity has been defined by a BMI ≥ 30 kg/m 2. The parturient has been classified in two groups: Non-obese: BMI ≤ 30 kg/m 2 , obese: BMI ≥ 30. Results: There were 703 (78.90%) Caesareans in emergency and 188 (21.09%) programmed Caesareans. The obesity which has been recovered at 286 parturient is 32.10%. The obese parturient also required more frequently several lumbar punctures (p < 0.001) at the time of the spinal anesthesia and more of conversion of the spinal anesthesia into a general anesthesia (p = 0.008). The postoperative complications: laryngeal pain, back pain and suppuration of the wound were more frequent at the obese parturient. Conclusion: Many changes led by pregnancy are added to those of the obesity to drive to functional changes, a reduction of the physiological reserve and finally to an in

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Section: Discussionsupporting

confidence: 55%

“…The difficulty of the lumbar puncture was more frequent (67.13% vs 47.93% of multiple puncture) at the obese parturient. This tendency has been returned by Vricella et al [10].…”

Section: Discussionmentioning

confidence: 65%

Complications of Obesity in Cesarized Parturients in the Teaching Centers of Cotonou

Hodé¹,

Zoumenou²,

Hounkpatin³

et al. 2018

OJEMD

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“…Complications of difficult catheter placement, inability to obtain adequate anesthetic levels, and duration are more common in increasing degrees of obesity. General anesthesia is used more frequently in morbidly obese patients and intraoperative hypotension can be a problem (45). Of about 1% maternal deaths that were anesthesia related, 75% were noted to be obese (46).…”

Section: Pregnancy Complicationsmentioning

confidence: 99%

Obesity

Chhibber¹

2011

Maternal-Fetal Evidence Based Guidelines

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KEY POINTS lThe preconception visit may be the single most important health care visit when viewed in the context of its effect on pregnancy. Height in meters and weight in kilograms should be recorded for all women at each doctor visit to allow for calculation of BMI. The BMI category should be reviewed with the patient, making sure she understands that her category is not normal. l Obesity is a risk factor for cardiovascular disease; diabetes; hypertension; stroke; osteoarthritis; gall stones; increased incidence of endometrial, breast, or colon cancer; cardiomyopathy; fatty liver; obstructive sleep apnea; urinary tract infections; other complications; and, most importantly, mortality. Prepregnancy obesity and excessive gestational weight gain are associated with increased risk of childhood obesity. l Preconception weight loss with diet, exercise, behavior change, and, if necessary, pharmacotherapy is recommended. Weight loss of at least 5% to 10% will help reduce the incidence of obesity-related comorbidities. l Preconception (and at first prenatal visit), check BP with a large cuff, fasting lipid profile and blood sugar, thyroid function tests, and overnight polysomnogram. In obese patients with chronic hypertension or type 2 diabetes, it is advisable to obtain an EKG and an echocardiogram. l Women with BMI !40 or !35 with comorbidities are candidates for bariatric surgery in the preconception or interconception period. Incidences of gestational diabetes and hypertension are reduced after gastric bypass surgery, especially if BMI is back to less than obese levels. Pregnant patients with bariatric surgery can be started on vitamin B12, folate, iron, and calcium if deficient. l

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“…In this context they are at much higher risk of cesarean section and general anesthesia . Obese women are also more likely to have failed anesthetic treatment including difficulties with regional analgesia placement , and intubation problems , while after cesarean section postoperative complications are more prevalent . Neonates born to women with a preconception BMI >50 kg/m 2 have an increased risk of macrosomia and are more likely to have neonatal hypoglycemia .…”

Section: Introductionmentioning

confidence: 99%

Pregnancy outcomes in a cohort of women with a preconception body mass index >50 kg/m²

Bonnesen

Secher

Møller

et al. 2013

Acta Obstet Gynecol Scand

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We describe characteristics and risk factors regarding pregnancy outcome in women with a preconception body mass index (BMI) >50 kg/m² compared with women with BMI ≤50 kg/m² in a retrospective population cohort study in singleton pregnancies from the Danish Medical Birth Registry. Results were analyzed as relative risks by a two-proportion z-test. Women with preconception BMI >50 kg/m² smoked, developed gestational diabetes and pre-eclampsia, and needed induction of labor more frequently than mothers with BMI ≤50 kg/m². Examination of the case records showed that many attempted vaginal delivery without epidural analgesia, 21% needed an emergency cesarean section (compared with 12% among women with BMI ≤50 kg/m²), and 25% underwent general anesthesia in this context. Many neonates were macrosomic and 34% needed neonatal intensive care and early feeding compared with 6% of neonates from women with BMI ≤50 kg/m². Women with an extremely high preconception BMI develop more pregnancy complications and their neonates appear affected by this as well.

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Anesthesia Complications During Scheduled Cesarean Delivery for Morbidly Obese Women

Cited by 12 publications

References 24 publications

Complications of Obesity in Cesarized Parturients in the Teaching Centers of Cotonou

Complications of Obesity in Cesarized Parturients in the Teaching Centers of Cotonou

Obesity

Pregnancy outcomes in a cohort of women with a preconception body mass index >50 kg/m²

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Anesthesia Complications During Scheduled Cesarean Delivery for Morbidly Obese Women

Cited by 12 publications

References 24 publications

Complications of Obesity in Cesarized Parturients in the Teaching Centers of Cotonou

Complications of Obesity in Cesarized Parturients in the Teaching Centers of Cotonou

Obesity

Pregnancy outcomes in a cohort of women with a preconception body mass index >50 kg/m2

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Product

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Pregnancy outcomes in a cohort of women with a preconception body mass index >50 kg/m²