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Am J Obstet Gynecol. 2011 Oct;205(4):370.e1-6. doi: 10.1016/j.ajog.2011.06.085. Epub 2011 Jun 29.

Impact of morbid obesity on epidural anesthesia complications in labor.

Author information

1
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.

Abstract

OBJECTIVE:

We sought to determine whether morbid obesity is associated with increased maternal hypotension or fetal heart rate (FHR) abnormalities after epidural anesthesia placement during labor.

STUDY DESIGN:

This was a retrospective cohort study of women undergoing epidural anesthesia during labor at term from April 2008 through July 2010.

RESULTS:

A total of 125 morbidly obese patients were matched for age and race with 125 normal-weight patients. Morbidly obese patients had more frequent persistent systolic (16% vs 4%, P = .003) and diastolic (49% vs 29%, P = .002) hypotension and more prolonged (16% vs 5%, P = .006) and late (26% vs 14%, P = .03) FHR decelerations. Increasing body mass index was associated with persistent systolic (odds ratio, 1.06; 95% confidence interval, 1.02-1.10) and diastolic (odds ratio, 1.04; 95% confidence interval, 1.01-1.06) hypotension after controlling for epidural bolus dose and hypertensive disorders.

CONCLUSION:

Morbidly obese women have more hypotension and prolonged FHR decelerations following epidural anesthesia during labor at term.

PMID:
21864821
DOI:
10.1016/j.ajog.2011.06.085
[Indexed for MEDLINE]
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