Objective
We sought to estimate the morbidity associated with regional anesthesia in morbidly
obese women undergoing scheduled cesarean delivery.
Study Design
This was a retrospective cohort study of women undergoing elective scheduled cesarean
delivery from September 2004 through December 2008.
Results
A total of 142 morbidly obese, 251 overweight and obese, and 185 normal-weight women
met inclusion criteria. Differences between groups were identified regarding: complicated
placement (5.6%, 2.8%, and 0%, respectively; P = .007), failure to establish (2%, 0%, and 0%, respectively; P = .047), and insufficient duration (4%, 0%, and 0%, respectively; P = .02) of regional anesthesia. The groups differed in the frequency of general anesthesia
(6%, 0%, and 0%, respectively; P = .003), intraoperative hypotension (3%, 0%, and 0%, respectively; P = .01), and overall anesthetic complications (8.4%, 0%, and 0%, respectively; P < .0001). Prepregnancy body mass index ≥40 kg/m2 (receiver operating characteristic area under the curve, 0.856; positive likelihood
ratio, 4.0) and delivery body mass index ≥45 kg/m2 (receiver operating characteristic area under the curve, 0.877; positive likelihood
ratio, 4.1) were predictive of anesthetic complications.
Conclusion
Morbidly obese women have significant risk for anesthesia complications during cesarean
delivery.
Key words
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Article info
Publication history
Published online: August 05, 2010
Accepted:
June 7,
2010
Received in revised form:
April 27,
2010
Received:
March 1,
2010
Footnotes
Reprints not available from the authors.
Cite this article as: Vricella LK, Louis JM, Mercer BM, et al. Anesthesia complications during scheduled cesarean delivery for morbidly obese women. Am J Obstet Gynecol 2010;203:276.e1-5.
Identification
Copyright
© 2010 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
