Anaesthetic and obstetric challenges of morbid obesity in caesarean deliveries--a study in South-eastern Nigeria

Afr Health Sci. 2012 Mar;12(1):54-7.

Abstract

Background: Morbid obesity of parturient has become very important in perinatal medicine because of a worldwide obesity epidemic. Morbid obesity of parturient is reportedly associated with severely increased anaesthetic and obstetric risk.

Objective: To determine the prevalence rate, anaesthetic and obstetric complications in morbidly obese parturient that had caesarean delivery in a Nigerian tertiary care centre.

Methods: The obstetric theatre records and case files were reviewed for caesarean deliveries in the University of Nigeria Teaching Hospital, Enugu, Nigeria from May 2008 to December 2010. A sample size of 250 patients, calculated based on a prevalence rate of 19%, confidence interval of 95% , a power of 80% and a finite population of zero was used to determine the prevalence rate of morbid obesity (Body Mass Index of greater than or equal to 35 kg/m(2)).

Results: There were thirty-one patients with morbid obesity (12.4%). The average Body Mass Index (BMI) was 38.3 kg/m(2)(SD ± 2.99). Other findings included macrosomia (7 or 25.8%), gestational diabetes (13%) and pregnancy induced hypertension (7 or 22.5%).There were two neonatal deaths but no maternal deaths.

Conclusion: The prevalence rate of morbid obesity is about 10% in Nigerian women of child bearing age. This mirrors a World Health Organisation report published in the World Health Organisation Global Information Base.

Keywords: anaesthetic; morbid obesity; obstetric.

MeSH terms

  • Adolescent
  • Adult
  • Anesthesia, Obstetrical / methods*
  • Anesthesia, Spinal / methods*
  • Body Mass Index
  • Cesarean Section / adverse effects*
  • Diabetes, Gestational / epidemiology
  • Female
  • Fetal Macrosomia / epidemiology
  • Hospitals, Teaching
  • Humans
  • Hypertension, Pregnancy-Induced / epidemiology
  • Infant, Newborn
  • Nigeria / epidemiology
  • Obesity, Morbid / complications*
  • Obesity, Morbid / epidemiology
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy Outcome
  • Prevalence
  • Retrospective Studies
  • Socioeconomic Factors
  • Tertiary Care Centers
  • Young Adult