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Pushing the Envelope in Obstetric Care: A Case Report of Cesarean Delivery in a Parturient with a BMI >100 kg m-2

Sangeeta Kumaraswami1, Itamar Futterman2, Suryanarayana Pothula1

  • 1Department of Anesthesiology, New York Medical College, Westchester Medical Center, 100, Woods Road, Valhalla, New York 10595, USA.

Case Reports in Anesthesiology
|July 21, 2020
PubMed

An increasing number of women with a body mass index (BMI) ≥ 60 kg m-2, referred to as super-super obesity, are requiring anesthetic care for labor and delivery. Management of these patients presents obstetric, anesthetic, and logistical challenges. We report our experience in the management of cesarean delivery in a parturient with a BMI of 112 kg m-2. Use of epidural anesthesia and performance of a supraumbilical transverse surgical incision with caudal placement of the panniculus resulted in optimal hemodynamic and ventilatory parameters. Effective multidisciplinary planning and communication is key. We present this case to highlight decision-making strategies and elucidate our approach in the management of this complex obstetric case.

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