Incidence of Complications Associated With Anesthesia in Obesity Parturient Undergoing Cesarean Delivery

Study Overview
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Brief Summary
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The incidence of obesity parturient has been increasing worldwide. There was a report revealing one third of pregnant women in United state considered obesity. Obesity is associated with increased in maternal and neonatal complications. Also, there was an increasing in the rate of cesarean delivery. Anesthetic management of the obese parturient is differ from non-obese parturients. There were higher risk of difficult intubation, failed intubation, pulmonary aspiration and difficult regional anesthesia such as spinal anesthesia or epidural catheter placement comparing with non-obese parturient. The aim of the study is to report complication associated with anesthesia in obese patients undergoing cesarean delivery in Single University hospital, Bangkok, THAILAND.

Detailed Description
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The incidence of obesity parturient has been increasing worldwide. There was a report revealing one third of pregnant women in United state considered obesity. Obesity is associated with increased in maternal and neonatal complications. Also, there was an increasing in the rate of cesarean delivery. Anesthetic management of the obese parturient is differ from non-obese parturients. There were higher risk of difficult intubation and difficult regional anesthesia such as spinal anesthesia or epidural catheter placement comparing with non-obese parturient. WHO categorised obesity into 3 classification; grade 1: BMI 30-34.9 kg/m2, grade 2: BMI 35-39.9 kg/m2, grade 3: BMI > 40 kg/m2. This study emphasised in grade 3 obese pregnant women (BMI>40 kg/m2) undergoing cesarean delivery that were at risk of increasing in anesthetic complications such as airway complications as well as complications derived from regional anesthesia eg. high spinal block, failed spinal block etc. Therefore, the primary objective of the study is to report complication associated with anesthesia in obese patients undergoing cesarean delivery in Single University hospital, Bangkok, THAILAND. The secondary objectives rate of postpartum haemorrhage, rate of hysterectomy and neonatal outcomes.

Official Title
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Incidence of Complications Associated With Anesthesia in Obesity Parturient Undergoing Cesarean Delivery- a Retrospective Review

Conditions
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Cesarean Section Complications, Anesthesia Complication, Obesity, Morbid

Intervention / Treatment
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* Procedure: Anesthesia; general or regional


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Pregnant women BMI>,= 40 kg/m2 underwent cesarean delivery Exclusion Criteria: Patients with gestational age <,= 24 weeks Patients with death fetus in Utero Multiple gestation Patients with intrapelvic cavity pathology eg. myoma uteri Patients with abnormal placentation Patients with polyhydramnios

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Procedure: Anesthesia; general or regional|General anesthesia: general anesthesia with endotracheal tube Regional anesthesia: spinal anesthesia, epidural anesthesia, combined spinal epidural anesthesia|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of complications | Incidence of maternal complications associated with anesthesia | intraoperative period to 24 hours postoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Incidence of obstetric-related complications | Incidence of maternal complicaitions associated with obstetrics eg. amount of hemorrhage, rate of hysterectomy, rate of blood transfusion | intraoperative period to 24 hours postoperative | 
| Neonatal outcomes | Neonate apgar score (ranging 0-10) | Neonate apgar score at 1-min and 5 min | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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obesity, anesthetic complications, maternal outcomes, neonatal outcomes, cesarean section