DALLAS -- The more obese a pregnant woman is at the time of delivery, the more likely she will deliver her baby by Cesarean section, according to a study by obstetric anesthesiologists at Duke University Medical Center.
Because of this, the researchers recommend that all obese women who come to a hospital in labor should consider having an epidural analgesia line placed in order to minimize the potential risks of general anesthesia if a C-section becomes necessary. An epidural involves the placement of a thin catheter into the epidural space near the spinal column, which allows physicians to introduce anesthetic agents that can be used to block the pain of vaginal delivery or provide anesthesia for a C-section. In a general anesthetic, the patient is unconscious; when an epidural is used, the patient is awake but cannot feel pain in the lower half of the body.
Anesthesiologists in most cases don't see expectant mothers until just a few hours before delivery, but the type of anesthesia used can directly affect the health of mother and baby. This is especially true of obese women, because physicians encounter more difficulty in successfully administering emergency general anesthesia to overweight patients.
Duke obstetric anesthesiologist Dr. Elizabeth Bell prepared the results of her study for presentation Monday (Oct. 12) at the annual meeting of the American Society of Anesthesiologists.
Bell reviewed the medical records of 2,493 mothers who gave birth at Duke University Hospital and whose height and weight was taken over a 16-month period, and found that 833, or one third, received a C-section. Then she calculated each patient's body mass index (BMI), which is considered the most reliable measurement of obesity, for all the mothers.
"We found that the patients who had C-sections had an average BMI of 53,
significantly higher than the average BMI of 31 for those delivering vaginally,"
Contact: Richard Merritt
Duke University Medical Center