ANESTHETIC CHALLENGES OF OBESE PARTURIENTS
Journal Title: INTERNATIONAL JOURNAL OF PURE MEDICAL RESEARCH - Year 2017, Vol 2, Issue 5
Abstract
Obese pregnant women have been reported to have increased risks of maternal, fetal, and neonatal mortality and morbidity compared with non-obese pregnant women. For example, the incidence of cesarean section is higher among obese than non-obese parturients. Moreover, caring for obese parturients is very challenging for all health team members, due to large body size, physiological changes of pregnancy, and associated medical comorbidities, including cardiovascular disease, fatty liver disease, pulmonary hypertension, depression, obstructive sleep apnea and degenerative joint disease. Therefore, early consultation with anesthesiologists is mandatory for obese parturients, allowing sufficient time for anesthesia planning and optimization. Neuraxial analgesia, however, should be started as soon as possible during labor, minimizing the need for general anesthesia. For caesarian delivery, the continuous catheter technique is better than the single shot spinal technique. It is also important not to jeopardize the mother’s life to save a compromised fetus. Thrombo-prophylaxis is essential due to an increased risk of thromboembolic events. Communication with the obstetric team is important for good care, and adequate postoperative pain control is essential for early mobilization.
Authors and Affiliations
Eynas O. Abdalla, Ismat ELsaigh, Santhosh Gopalakrishnan
Keywords
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