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Anesthesia for the Morbidly Obese Pregnant Patient

  • Holly Ende
  • Bhavani Kodali
Chapter

Abstract

There is an ongoing obesity epidemic in the United States, with more than 1/3 of Americans being classified as overweight or obese. Approximately 20% of pregnant women are diagnosed as obese by antenatal body mass index. The physiologic changes associated with both pregnancy and obesity can have negative impacts on the cardiovascular, pulmonary, gastrointestinal, endocrine, and hematologic systems. Morbid obesity in pregnancy is associated with worsened morbidity and mortality for both mother and fetus, including higher rates of hypertensive disorders of pregnancy, gestational diabetes, thromboembolic disease, and need for operative delivery. Obesity also complicates the anesthetic management for both vaginal and cesarean delivery, including increased risks of difficult neuraxial placement, neuraxial catheter failure, and difficult airway.

Keywords

Physiologic changes of pregnancy Maternal morbidity and mortality Labor and vaginal delivery Cesarean delivery Postpartum complications 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Vanderbilt University Medical Center, Department of AnesthesiologyNashvilleUSA
  2. 2.Brigham and Women’s Hospital, Department of Anesthesiology, Perioperative, and Pain MedicineBostonUSA

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