Mock delivery drill in a super morbidly obese parturient

  • Alaa SabbahiEmail author
  • Susan L. Haley
  • Rob Tanzola
  • Rachel Rooney
  • Kim E. Turner

To the Editor,

There are several published reports on the anesthetic management of super morbidly obese parturients during obstetrical deliveries.1-4 Nevertheless, to our knowledge, there are no reports on the procedural preparations required beforehand.

With appropriate institutional ethics approval and patient consent, we describe a “mock delivery” performed in preparation for the planned vaginal delivery of a 38-yr-old super morbidly obese (216 kg) G4 P0 parturient with a body mass index (BMI) of 86.5 kg·m−2. Her medical history included mild asthma, anxiety, and psoriasis. Airway examination showed a Mallampati class II airway, normal neck extension, and normal thyromental distance.

At 37 weeks gestation, the patient attended the labour and delivery ward where anesthesiology, obstetrics, and nursing performed a “mock delivery”, including Cesarean delivery. After the patient’s arrival in a bariatric wheelchair, the first unforeseen obstacle was obtaining an appropriately sized...


Conflicts of interest

None declared.

Editorial responsibility

This submission was handled by Dr. Philip M. Jones, Associate Editor, Canadian Journal of Anesthesia.


  1. 1.
    Kuczkowski KM. Labor analgesia for the morbidly obese parturient: an old problem—new solution. Arch Gynecol Obstet 2005; 271: 302-3.CrossRefGoogle Scholar
  2. 2.
    Polin CM, Hale B, Mauritz AA, et al. Anesthetic management of super-morbidly obese parturients for cesarean delivery with a double neuraxial catheter technique: a case series. Int J Obstet Anesth 2015; 24: 276-80.CrossRefGoogle Scholar
  3. 3.
    Benevides ML, Brandão VC, Lovera JI. Perioperative management of a morbidly obese pregnant patient undergoing cesarean section under general anesthesia - case report. Braz J Anesthesiol 2016; 66: 418-22.CrossRefGoogle Scholar
  4. 4.
    McDonnell NJ, Paech MJ. The management of a super morbidly obese parturient delivering twins by caesarean section. Anaesth Intensive Care 2007; 35: 979-83.CrossRefGoogle Scholar

Copyright information

© Canadian Anesthesiologists' Society 2019

Authors and Affiliations

  1. 1.Department of Anesthesiology and Intensive CareKing Abdulaziz UniversityJeddahSaudi Arabia
  2. 2.Department of Anesthesiology and Perioperative MedicineQueen’s UniversityKingstonCanada

Personalised recommendations