Anesthesia Complication, Cesarean Section Complications, Obesity, Morbid
Conditions
Keywords
anesthetic complications, maternal outcomes, neonatal outcomes, cesarean section, obesity
Brief summary
The incidence of obesity parturient has been increasing worldwide. There was a report revealing one third of pregnant women in United state considered obesity. Obesity is associated with increased in maternal and neonatal complications. Also, there was an increasing in the rate of cesarean delivery. Anesthetic management of the obese parturient is differ from non-obese parturients. There were higher risk of difficult intubation, failed intubation, pulmonary aspiration and difficult regional anesthesia such as spinal anesthesia or epidural catheter placement comparing with non-obese parturient. The aim of the study is to report complication associated with anesthesia in obese patients undergoing cesarean delivery in Single University hospital, Bangkok, THAILAND.
Detailed description
The incidence of obesity parturient has been increasing worldwide. There was a report revealing one third of pregnant women in United state considered obesity. Obesity is associated with increased in maternal and neonatal complications. Also, there was an increasing in the rate of cesarean delivery. Anesthetic management of the obese parturient is differ from non-obese parturients. There were higher risk of difficult intubation and difficult regional anesthesia such as spinal anesthesia or epidural catheter placement comparing with non-obese parturient. WHO categorised obesity into 3 classification; grade 1: BMI 30-34.9 kg/m2, grade 2: BMI 35-39.9 kg/m2, grade 3: BMI \> 40 kg/m2. This study emphasised in grade 3 obese pregnant women (BMI\>40 kg/m2) undergoing cesarean delivery that were at risk of increasing in anesthetic complications such as airway complications as well as complications derived from regional anesthesia eg. high spinal block, failed spinal block etc. Therefore, the primary objective of the study is to report complication associated with anesthesia in obese patients undergoing cesarean delivery in Single University hospital, Bangkok, THAILAND. The secondary objectives rate of postpartum haemorrhage, rate of hysterectomy and neonatal outcomes.
Interventions
PROCEDUREAnesthesia; general or regional
General anesthesia: general anesthesia with endotracheal tube Regional anesthesia: spinal anesthesia, epidural anesthesia, combined spinal epidural anesthesia
Sponsors
Mahidol University
Study design
Observational model
CASE_ONLY
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Pregnant women BMI\>,= 40 kg/m2 underwent cesarean delivery
Exclusion criteria
* Patients with gestational age \<,= 24 weeks * Patients with death fetus in Utero * Multiple gestation * Patients with intrapelvic cavity pathology eg. myoma uteri * Patients with abnormal placentation * Patients with polyhydramnios
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of complications | intraoperative period to 24 hours postoperative | Incidence of maternal complications associated with anesthesia |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of obstetric-related complications | intraoperative period to 24 hours postoperative | Incidence of maternal complicaitions associated with obstetrics eg. amount of hemorrhage, rate of hysterectomy, rate of blood transfusion |
| Neonatal outcomes | Neonate apgar score at 1-min and 5 min | Neonate apgar score (ranging 0-10) |
Countries
Thailand
Outcome results
None listed