Anesthetic and obstetric outcomes in morbidly obese parturients: a 20-year follow-up retrospective cohort study

Abstract Background In 1993, Hood and Dewan published the results of a trial comparing obstetric and anesthetic outcomes of 117 morbidly obese parturients with matched controls. The authors demonstrated a higher initial epidural anesthesia failure rate, a higher cesarean delivery rate and an increased risk of obstetric complications. We replicated the previous study to provide updated information on outcomes in the morbidly obese pregnant population. We hypothesized that morbidly obese women would still have higher complication and failure rates compared to matched controls and that general anesthesia would be less commonly used than in the previous study. Methods The medical records of 230 patients weighing >136kg (300pounds) were compared to matched controls: the next patient delivered by the same obstetrician with a weight Results The mean weight of the morbidly obese group was 53.4±6.6kg/m 2 compared to 31.1±5.4kg/m 2 in the control group. Fifty percent of morbidly obese women required cesarean delivery compared to 32% of controls ( P P P P P P P Conclusions Morbidly obese parturients are still at increased risk for antenatal comorbidities, failed labor analgesia, longer first stage of labor and operative delivery. Replacement labor epidural catheters and general anesthesia for cesarean delivery are less commonly required anesthetic techniques compared to the original study.