Anesthetic Considerations in the Care of the Parturient with Obesity

Abstract

Purpose of Review

The goal of this review is to summarize recent findings on the physiologic alterations posed by maternal obesity and implications for the anesthetic care of mother and infant.

Recent Findings

Obesity is rising nationally and globally. Many studies show associations between excess weight during pregnancy with increased morbidity and mortality. Parturients with obesity are at a higher risk of endocrine, cardiac, pulmonary, and post-operative complications. A neuraxial catheter is recommended given the higher risk of an operative delivery. Consultation by an obstetric anesthesiologist is helpful for patient education and planning.

Summary

Maternal mortality is the highest in the USA compared to other high-income countries. Understanding the association between obesity and maternal morbidity and mortality is critically important. The obstetric anesthesiologist can improve care by understanding not only the patient's medical needs, but also anticipating complications and having appropriate equipment available. Multi-disciplinary care optimizes outcomes.

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