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Anesthetic Outcomes in Super Obese Parturients
Abstract Number: F2B-3
Abstract Type: Original Research
INTRODUCTION: Obesity is an epidemic and continuing to increase in the US (1). Maternal obesity is concerning because it increases maternal and neonatal morbidity and mortality (2). Managing obese parturients can be difficult due to technical challenges and patients’ comorbidities (3). Few data exist regarding super obese (BMI > 50) parturients. We previously reported an analysis of obstetric and neonatal outcomes among super obese versus obese and non-obese counterparts (4). In this study we compare anesthetic outcomes among these three cohorts; we also present a comprehensive chart review of the super obese patients’ anesthetic management.
METHODS: We queried the Perinatal Database and the Department of Anesthesia Billing Database at our university hospital to identify patients who delivered or had obstetric anesthesia care during 2011 through 2013. We garnered demographic and outcome variables from the databases and compared super obese (BMI >50), obese (BMI >30/<50) and non-obese (BMI <30) cohorts. We then performed a chart review to determine anesthetic outcomes and complications in the super obese patients only. Comparisons were made with X2, Fischer’s Exact, Kruskal-Wallis, and Mann-Whitney U Test, with P<0.05 required to reject the null hypothesis.
RESULTS: We identified 150 super obese, 2314 obese and 2131 non-obese patients. 145 super obese patients had an anesthetic, with 129 complete records, 7 incomplete records, and 9 missing records. Super obese patients were older than obese and non-obese patients, and less likely to be nulliparous than non-obese women (table). They had a higher rate of cesarean delivery, and lower rates of vaginal delivery and operative vaginal delivery than obese and non-obese women. Both super-obese and obese patients were more likely to receive neuraxial labor analgesia and less likely to undergo general anesthesia than non-obese patients. Review of super obese patients’ charts revealed few anesthetic complications (table).
CONCLUSION: Although anesthetic care of super obese parturients is challenging, few anesthetic complications occurred, possibly because these patients have higher rates of neuraxial labor analgesia and lower rates of general anesthesia than non-obese counterparts. Further research should focus on comparative studies.
1. Branum: Nat Vital Stat Rep 2016:65:6
2. Cedergren: Am J Obstet Gyne 2004:103:2
3. Tonindandel: IJOA 2014:23: 357
4. Tsao: SOAP 2015 Annual Meeting; Abstract F-60