NYMC Faculty Publications

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

DOI

10.1155/2020/5498584

Journal Title

Case Reports in Anesthesiology

First Page

5498584

Last Page

5498584

Document Type

Case Report

Publication Date

5-2020

Department

Anesthesiology

Second Department

Obstetrics and Gynecology

Third Department

Urology

Abstract

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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