TY - JOUR
T1 - The Challenges of Obesity and Obstetric Anaesthesia
AU - Saravanakumar, K
AU - Rao, SG
AU - Cooper, Griselda
PY - 2006/11/1
Y1 - 2006/11/1
N2 - PURPOSE OF REVIEW: The aim of this article is to review the clinical challenges of obesity in obstetrics from the anaesthetist's viewpoint. RECENT FINDINGS: The prevalence of obesity continues to increase both in the community and on the labour ward. Women who have undergone bariatric surgery are also on rise. During pregnancy, obesity is associated with hypertensive disease (chronic hypertension and preeclampsia), diabetes mellitus (pregestational and gestational), respiratory disorders (asthma and sleep apnoea), thromboembolic disease, caesarean section and infections (primarily urinary tract infections, wound infections and endometritis). Obesity is a risk factor for anaesthesia-related maternal mortality. Obese women are not only at high-risk of airway complications, cardiopulmonary dysfunction, perioperative morbidity and mortality but also pose technical challenges. Obesity also influences the fetal outcomes. Increasing use of regional techniques contributes to the reduced anaesthesia-related maternal mortality. Preconception counselling, antenatal screening and anaesthetic assessment are strongly encouraged. SUMMARY: Effective communication and good teamwork between an anaesthetist and an obstetrician are essential for the care of obese parturients. A more liberalized use of regional techniques may be a means of further reducing the anaesthesia-related maternal mortality.
AB - PURPOSE OF REVIEW: The aim of this article is to review the clinical challenges of obesity in obstetrics from the anaesthetist's viewpoint. RECENT FINDINGS: The prevalence of obesity continues to increase both in the community and on the labour ward. Women who have undergone bariatric surgery are also on rise. During pregnancy, obesity is associated with hypertensive disease (chronic hypertension and preeclampsia), diabetes mellitus (pregestational and gestational), respiratory disorders (asthma and sleep apnoea), thromboembolic disease, caesarean section and infections (primarily urinary tract infections, wound infections and endometritis). Obesity is a risk factor for anaesthesia-related maternal mortality. Obese women are not only at high-risk of airway complications, cardiopulmonary dysfunction, perioperative morbidity and mortality but also pose technical challenges. Obesity also influences the fetal outcomes. Increasing use of regional techniques contributes to the reduced anaesthesia-related maternal mortality. Preconception counselling, antenatal screening and anaesthetic assessment are strongly encouraged. SUMMARY: Effective communication and good teamwork between an anaesthetist and an obstetrician are essential for the care of obese parturients. A more liberalized use of regional techniques may be a means of further reducing the anaesthesia-related maternal mortality.
UR - http://www.scopus.com/inward/record.url?scp=33750966747&partnerID=8YFLogxK
U2 - 10.1097/GCO.0b013e3280101019
DO - 10.1097/GCO.0b013e3280101019
M3 - Article
C2 - 17099334
SN - 1040-872X
VL - 18
SP - 631
EP - 635
JO - Current Opinion in Obstetrics and Gynaecology
JF - Current Opinion in Obstetrics and Gynaecology
ER -