Anesthetic implications of morbid obesity during pregnancy; a literature based review

• Published in: International journal of surgery open Vol. 40; p. 100444
• Main Authors: Mossie, Addisu, Ali, Siraj Ahmed, Tesema, Hailemariam Getachew
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-03-2022
• Subjects: Anesthesia; Morbid obesity; Obesity; Pregnancy; Pregnancy; Obesity; Anesthesia; Morbid obesity
• ISSN: 2405-8572; 2405-8572
• DOI: 10.1016/j.ijso.2022.100444

The prevalence of maternal obesity has increased globally and more than 70% of overweight pregnant women occurred in upper middle income and lower middle income countries. In Ethiopia, the proportion of overweight and obesity among women has increased from 3% in 2000 to 8% in 2016. This indicates that the prevalence of maternal obesity is increasing both globally and in our country. This review summarized recent findings on anesthetic implications of morbid obesity in pregnancy.
This study aimed to identify the clinical implication of morbid obesity during pregnancy on anesthesia management for pregnant women.
Literature was searched from electronic databases (including PubMed, Google Scholar, CINAHL, and Cochrane database of systematic reviews that are published in English language from 2010 to 2021.
Obesity and pregnancy are both factors that complicate anesthesia management. Airway management is a challenge for all obese parturients because their short safe apnea time and altered anatomical changes. Apneic oxygenation and ramped position create better intubating condition by increasing safe apnea time and improved the laryngeal view. Use of a hierarchical, opioid-sparing pain management approach to provide effective analgesia in morbidly obese parturients as opioids has increased risk of respiratory complications and abdominal field blocks may technically difficult.
•The prevalence maternal obesity has increased globally.•More than 70% occurred in upper middle income and lower middle income countries.•Obesity and pregnancy are both factors that complicate anesthesia management.•Airway management during anesthesia is a challenge for all obese parturients.