Skip to main content
Log in

Anaesthetic outcomes in obese parturients: the effect of assessment in the high-risk clinic

  • Original Article
  • Published:
Irish Journal of Medical Science Aims and scope Submit manuscript

Abstract

Background

Obese parturients are at high risk of complications during anaesthesia and early use of epidural analgesia in labour has been recommended for obese patients during labour.

Aim

To assess the outcome of anaesthesia outpatient consultation for obese parturients.

Methods

We retrospectively compared outcomes of obese patients antenatally and an obese and non-obese control group over a 1-year period. Outcomes included potential airway problems, anaesthetic for caesarean section, use and success of epidural analgesia and cervical dilation at epidural placement.

Results

The proportion of obese patients who had predictable intubation difficulty was low (5%). Epidural use analgesia in labour (69 vs 36 vs 66%, P = 0.148) was similar between groups (obese, obese controls and non-obese controls, respectively). Cervical dilation at the time of epidural insertion in the obese group (2.0, 1.0–3.0 cm) was not different from obese controls (3.0, 1.75–5.75 cm). There was no difference in the number of attempts required to site the epidural between groups or the number of patients that required resiting of the epidural catheter. General anaesthesia was not required in any emergency case in this group.

Conclusion

The outcomes of obese patients attending the anaesthetic clinic were mixed. Not all patients who were to advised have epidurals did so but those who did requested them in early labour and there was no requirement for general anaesthesia during emergency caesarean section and adverse airway events were avoided in this group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Davies GA, Maxwell C, McLeod L et al (2010) SOGC clinical practice guidelines: obesity in pregnancy. No. 239, February 2010. Int J Gynaecol Obstet 110:167–173

    Article  PubMed  Google Scholar 

  2. Davies GA, Maxwell C, McLeod L et al (2010) Obesity in pregnancy. J Obstet Gynaecol Can. 32:165–173

    PubMed  Google Scholar 

  3. Samsoon GLT, Young JRB (1987) Difficult tracheal intubation: a retrospective study. Anaesthesia 42:487–490

    Article  PubMed  CAS  Google Scholar 

  4. Kanagalingam MG, Forouhi NG, Greer IA, Sattar N (2005) Changes in booking body mass index over a decade: retrospective analysis from a Glasgow maternity hospital. BJOG. 112:1431–1433

    Article  PubMed  Google Scholar 

  5. Macarthur AJ, Ostheimer GW (2008) “What’s new in obstetric anesthesia” lecture. Anesthesiology. 108:777–785

    Article  PubMed  Google Scholar 

  6. Sebire NJ, Jolly M, Harris JP et al (2001) Maternal obesity and pregnancy outcome: a study of 287, 213 pregnancies in London. Int J Obes Relat Metab Disord. 25:1175–1182

    Article  PubMed  CAS  Google Scholar 

  7. Yu CK, Teoh TG, Robinson S (2006) Obesity in pregnancy. BJOG. 113:1117–1125

    Article  PubMed  CAS  Google Scholar 

  8. Barau G, Robillard PY, Hulsey TC et al (2006) Linear association between maternal pre-pregnancy body mass index and risk of caesarean section in term deliveries. BJOG. 113:1173–1177

    Article  PubMed  CAS  Google Scholar 

  9. Burstein E, Levy A, Mazor M, Wiznitzer A, Sheiner E (2008) Pregnancy outcome among obese women: a prospective study. Am J Perinatol 25:561–566

    Article  PubMed  Google Scholar 

  10. Ehrenberg HM, Durnwald CP, Catalano P, Mercer BM (2004) The influence of obesity and diabetes on the risk of cesarean delivery. Am J Obstet Gynecol 191:969–974

    Article  PubMed  CAS  Google Scholar 

  11. Flick AA, Brookfield KF, De la Torre L, Tudela CM, Duthely L, Gonzalez-Quintero VH (2010) Excessive weight gain among obese women and pregnancy outcomes. Am J Perinatol 27:333–338

    Article  PubMed  Google Scholar 

  12. Stepan H, Scheithauer S, Dornhofer N, Kramer T, Faber R (2006) Obesity as an obstetric risk factor: does it matter in a perinatal center? Obesity (Silver Spring) 14:770–773

    Article  Google Scholar 

  13. Perlow JH, Morgan MA (1994) Massive maternal obesity and perioperative cesarean morbidity. Am J Obstet Gynecol 170:560–565

    PubMed  CAS  Google Scholar 

  14. Barnardo PD, Jenkins JG (2000) Failed tracheal intubation in obstetrics: a 6-year review in a UK region. Anaesthesia 55:690–694

    Article  PubMed  CAS  Google Scholar 

  15. Munnur U, de Boisblanc B, Suresh MS (2005) Airway problems in pregnancy. Crit Care Med 33:S259–S268

    Article  PubMed  Google Scholar 

  16. Roofthooft E (2009) Anesthesia for the morbidly obese parturient. Curr Opin Anaesthesiol 22:341–346

    Article  PubMed  Google Scholar 

  17. Bamgbade OA, Khalaf WM, Ajai O, Sharma R, Chidambaram V, Madhavan G (2009) Obstetric anaesthesia outcome in obese and non-obese parturients undergoing caesarean delivery: an observational study. Int J Obstet Anesth 18:221–225

    Article  PubMed  CAS  Google Scholar 

  18. Dresner M, Brocklesby J, Bamber J (2006) Audit of the influence of body mass index on the performance of epidural analgesia in labour and the subsequent mode of delivery. BJOG 113:1178–1181

    Article  PubMed  CAS  Google Scholar 

  19. Hood DD, Dewan DM (1993) Anesthetic and obstetric outcome in morbidly obese parturients. Anesthesiology 79:1210–1218

    Article  PubMed  CAS  Google Scholar 

  20. Robinson HE, O’Connell CM, Joseph KS, McLeod NL (2005) Maternal outcomes in pregnancies complicated by obesity. Obstet Gynecol 106:1357–1364

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The financial support was obtained from internal funds only.

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to C. McCaul.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Aslani, A., Husarova, V., Ecimovic, P. et al. Anaesthetic outcomes in obese parturients: the effect of assessment in the high-risk clinic. Ir J Med Sci 181, 93–97 (2012). https://doi.org/10.1007/s11845-011-0762-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-011-0762-9

Keywords

Navigation