MATERNAL OBESITY: ANESTHETIC IMPLICATIONS & PERIOPERATIVE OUTCOME
A PROSPECTIVE STUDY OF 1032 PREGNANCIES OVER A YEAR
INTRODUCTION: The change in the life style has caused increase in the prevalence of
maternal obesity increasing the maternal and neonatal morbidity.
AIM: To evaluate the anesthetic implications and perioperative outcome of parturients with
BMI> 30 kg/m2 who underwent caesarean section and those requesting Labour Epidurals.
SUBJECTS AND METHOD: This prospective study is done in Fernandez Hospital for Women
& Newborn, Hyderabad between Jan. 2014 and Jan. 2015 over a period of 1year. The
pregnant patients were analyzed as 2 groups.
Group A: Obese Class I BMI 30 –34.9
Group B: Obese Class II and III BMI - >35
RESULTS:
A total of 1032 patients with BMI > 30 were analyzed. The incidence of obesity is 22.5% in
our hospital. The statistical significance between Group A & Group B was analyzed by chi
square test and a P value of <0.05 was taken as statistically significant.
BMI>30 = 1032 (22.5%)
Total no of LSCS +LA = 4559
BMI 30- 34.9
Group A = 748
BMI > 35
Group B = 284
Total no of patients with BMI > 30 = 1032
S.NO
Parameter
HDP / PE
BMI 30 - 34.9
Group A = 748
223 (29.81%)
BMI > 35
Group B = 284
109 (38.38%)
1.
2.
GDM
53 (7.08%)
98 (34.50%)
3
Hypothyroidism
65 (8.6%)
24 (9.68%)
4
PPH
75 (10.0%)
68 (23.94%)
5
Duration of Surgery in minutes
61.25± 16.02
73.78±16.18
6
Wound Infection
0
01 (0.35%)
6
Preterm delivery (< 36wks)
64 (8.5%)
48 (16.9%)
7
Neonatal RD
58 (7.75%)
45 (15.84%)
Anaesthetic complications/ technical hitches
S.NO
Group A
1
Technically difficult
14.9%
2
SAB >3attempts
8.66%
3
Needed supplementation
1.57%
4
Repeat SAB
3.08%
Group B
68.4%
32.38%
1.9%
6.5%
5
6
7
8
9
10
High spinal
Hypotension
Fall in saturation <94%
Failed regional - GA
GA with antecedent problems
Mean Hospital Stay
NIL
18.1%
NIL
2.36%
NIL
3.48days
1.08%
32.3%
0. 8%
1.3%
NIL
6.5days
CONCLUSION: Maternal obesity is associated with increased materno fetal morbidity,
anaesthetic and peri operative risks. The magnitude of risk increases with the degree of
obesity.