ANESTHETIC MANAGEMENT OF A MORBIDLY OBESE PARTURIENT UNDERGOING CESAREAN SECTION

Obesity has reached an epidemic proportion globally with a comparable rise in prevalence among women in the reproductive age. Not surprisingly, the number of obese parturients has more than doubled in the last 10 years. Obesity per se has been identified as a significant risk factor for respiratory and infectious complications in general surgery and for anaesthesia related mortality in obstetrics. When compared to normal weight parturients obese patients are at increased risk of having either concurrent medical problems or superimposed antenatal diseases including pre-eclampsia and gestational diabetes. Complications during labor such as intrapartum fetal distress, failure to progress, abnormal presentation necessitating instrumental delivery and cesarean section are more common. In addition there is an increased incidence of deep vein thrombosis, hypoxaemia, and wound infections perioperatively. Furthermore, the anaesthetist frequently has to deal with technical difficulties regarding airway management and regional anesthesia. This case report of a morbidly obese parturient undergoing cesarean section highlights the complexity and challenges that are associated with the anaesthetic and obstetric surgical care of this patient population.