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

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 cesa...

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Main Authors: Sangeeta Kumaraswami, Itamar Futterman, Suryanarayana Pothula, Geetha P. Rajendran, Ashutosh Kaul
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Case Reports in Anesthesiology
Online Access:http://dx.doi.org/10.1155/2020/5498584
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author Sangeeta Kumaraswami
Itamar Futterman
Suryanarayana Pothula
Geetha P. Rajendran
Ashutosh Kaul
author_facet Sangeeta Kumaraswami
Itamar Futterman
Suryanarayana Pothula
Geetha P. Rajendran
Ashutosh Kaul
author_sort Sangeeta Kumaraswami
collection DOAJ
description 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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publishDate 2020-01-01
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series Case Reports in Anesthesiology
spelling doaj-art-b632f359dcad4e2e9b0850eb00dce6ff2025-08-20T03:20:55ZengWileyCase Reports in Anesthesiology2090-63822090-63902020-01-01202010.1155/2020/54985845498584Pushing the Envelope in Obstetric Care: A Case Report of Cesarean Delivery in a Parturient with a BMI >100 kg m−2Sangeeta Kumaraswami0Itamar Futterman1Suryanarayana Pothula2Geetha P. Rajendran3Ashutosh Kaul4Department of Anesthesiology, New York Medical College, Westchester Medical Center, 100, Woods Road, Valhalla, New York 10595, USADepartment of Obstetrics and Gynecology, New York Medical College, Westchester Medical Center, 100, Woods Road, Valhalla, New York 10595, USADepartment of Anesthesiology, New York Medical College, Westchester Medical Center, 100, Woods Road, Valhalla, New York 10595, USADepartment of Obstetrics and Gynecology, New York Medical College, Westchester Medical Center, 100, Woods Road, Valhalla, New York 10595, USADepartment of Surgery, New York Medical College, Westchester Medical Center, 100, Woods Road, Valhalla, New York 10595, USAAn 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.http://dx.doi.org/10.1155/2020/5498584
spellingShingle Sangeeta Kumaraswami
Itamar Futterman
Suryanarayana Pothula
Geetha P. Rajendran
Ashutosh Kaul
Pushing the Envelope in Obstetric Care: A Case Report of Cesarean Delivery in a Parturient with a BMI >100 kg m−2
Case Reports in Anesthesiology
title Pushing the Envelope in Obstetric Care: A Case Report of Cesarean Delivery in a Parturient with a BMI >100 kg m−2
title_full Pushing the Envelope in Obstetric Care: A Case Report of Cesarean Delivery in a Parturient with a BMI >100 kg m−2
title_fullStr Pushing the Envelope in Obstetric Care: A Case Report of Cesarean Delivery in a Parturient with a BMI >100 kg m−2
title_full_unstemmed Pushing the Envelope in Obstetric Care: A Case Report of Cesarean Delivery in a Parturient with a BMI >100 kg m−2
title_short Pushing the Envelope in Obstetric Care: A Case Report of Cesarean Delivery in a Parturient with a BMI >100 kg m−2
title_sort pushing the envelope in obstetric care a case report of cesarean delivery in a parturient with a bmi 100 kg m 2
url http://dx.doi.org/10.1155/2020/5498584
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