Iranian Society of Gynecology Oncology

Authors

1 Anesthesiology Research Center, Department of Anesthesiology, Alzahra hospital, Guilan University of Medical Sciences, Rasht, Iran

2 Reproductive Health Research Center, Department of Obstetrics and Gynecology, Al-Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

3 Reproductive Health Research Center, Department of Obstetrics and Gynecology, Al-Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran/phone

4 Education Development Center, Guilan University of Medical Sciences, Rasht, Iran

Abstract

Having body mass index more than 29 is described as obesity in pregnancy. Anesthesia management in these patients has always been challenging. A 41-year-old woman, at 37weeks’ gestation with the weight of 200kg and body mass index of 66/05 was admitted with complaint of pain to Al-Zahra Hospital in Rasht. She reported a history of two previous caesarean sections and high blood sugar and hypothyroidism which were under control by drugs. The Anesthesiology team decided to choose Continuous Spinal Anesthesia method for her. After performing anesthesia, cesarean delivery was done and a female neonate was born with Apgar score of 5-9. They were discharged from the hospital in good condition after two days. Based on the results of this study, CSA approach is a suitable method for anesthesia management in cesarean section of obese patients. Also it is necessary to recommend these patients to refer to anesthesia counseling clinics before giving birth.

Keywords

  1. 1. bin Giloi N, Lin CLS, Payus AO, Mac Guad R, Murugaiah C, Soe MZ, et al. Ultrasound Subcostal Approach Transversus Abdominis Plane Block in Morbidly Obese Patient. Borneo Journal of Medical Sciences. 2019;13(3):43-. 2. Peyman N, Esmaeili H. The relationship between obesity and complications during pregnancy and childbirth in Dargaz: A cross sectional study. Journal of North Khorasan University of Medical Sciences. 2017;8(3):383-93. 3. Basirat Z, Kashifard M, Yazdani S. Successful Management of Pregnancy in Patient with Severe Morbid Obesity. Babol Univ Med Sci. 2012;14(5):95-2. 4. Ootaki C. Maternal morbid obesity and anesthesia management. Hypertension Research in Pregnancy. 2018:HRP2017-009. 5. Lamon AM, Habib AS. Managing anesthesia for cesarean section in obese patients: current perspectives. Local regional anesthesia. 2016;9:45. 6. McKinney D. Morbid Obesity and Pregnancy: A Case Study. The International Student Journal of Nurse Anesthesia. 2014;13(1):46-4. 7. Benevides ML, Brandão VCM, Lovera JIA. Perioperative management of a morbidly obese pregnant patient undergoing cesarean section under general anesthesia-case report. Revista brasileira de anestesiologia. 2016;66(4):418-22. 8. Davoodabadi M, Vakilian K. The effect of maternal overweight and obesity on the rate of cesarean section. Journal of Arak University of Medical Sciences. 2013;15(9):72-6. 9. McChlery S. The Perioperative Care of a Super Morbidly Obese Pregnant Woman: A Case Study. Journal of Perioperative Practice. 2007;17(11). 10. Wada K, Kawamata T, Sonoda H, Yamazaki Y, Morichika M, Kozuka Y, et al. Anesthetic management of cesarean section in a patient with severe obesity. Masui The Japanese journal of anesthesiology. 2003;52(8):903-5. 11. Sadeghi A, Razavi S, Gachkar L. Evaluation of effective parameters for method of anesthesia in cesarean section. Journal of Iranian Society Anesthesiology and Intensive Care. 2008;2:52-7. 12. Saravanakumar K, Rao SG, Cooper GM. The challenges of obesity and obstetric anaesthesia. Current Opinion in Obstetrics Gynecology. 2006;18(6):631-5. 13. Saravanakumar K, Rao S, Cooper G. Obesity and obstetric anaesthesia. Anaesthesia. 2006;61(1):36-48. 14. Marschall K. Stoelting's Anesthesia and Co-Existing Disease, 7th Edition. Philadelphia,: elsevier; 2018.www.elsevier.com/permissions. 15. Bell J, Bell S, Vahratian A, Awonuga AOJEJoO. Abdominal surgical incisions and perioperative morbidity among morbidly obese women undergoing cesarean delivery. European Journal of Obstetrics Gynecology Reproductive Biology. 2011;154(1):16-9.