Poster Presentation: The Impact of Maternal Obesity and Additional Surgical Factors on Cesarean Delivery Duration-The Impact of Maternal Obesity and Additional Surgical Factors on Cesarean Delivery Duration

The Impact of Maternal Obesity and Additional Surgical Factors on Cesarean Delivery Duration

Pdf Summary

The 2024 study by the Mayo Foundation for Medical Education and Research investigates the impact of maternal obesity and additional surgical factors on cesarean delivery (CD) duration. The primary outcome is the duration from block placement to incision closure, with secondary outcomes focused on specific time periods influenced by BMI, such as time to complete neuraxial block, overall CD duration, surgical preparation time, incision to delivery, and delivery to closure. The study also examines the influence of prior CDs and concurrent procedures on CD time, factors affecting the choice of neuraxial anesthesia, OB anesthesia fellowship training, conversion rates to general anesthesia (GA), and the rate of epidural blood patch as a marker for post-dural puncture headache (PDPH).<br /><br />Key findings reveal that maternal obesity poses unique challenges and increased risks, leading to longer CD durations. Factors contributing to increased time include BMI, the number of previous CDs, and concurrent procedures. While combined spinal-epidural (CSE) anesthesia might provide prolonged anesthesia duration with similar placement times as spinal anesthesia for patients with a BMI of 50 or greater, spinal anesthesia remains adequate for most CD cases.<br /><br />The study acknowledges limitations, primarily due to its retrospective design and the inability to determine the reasons behind neuraxial technique choices and maternal satisfaction. The study population may not be representative of all patient groups.<br /><br />Suggestions for future research include studying the administration of adjunct anesthetics during CD, conversion to GA, and further analysis of patients receiving multi-modal analgesic and anesthetic adjuncts.<br /><br />The conclusion emphasizes the complexity of caring for obese patients undergoing CD, which requires thorough anticipation, planning, and evaluation to determine the optimal anesthetic technique. Special consideration is advised for catheter-based anesthesia in patients with a BMI over 50.<br /><br />The study is supported by the Mayo Clinic, with grants from the National Center for Advancing Translational Sciences (NCATS) and the National Institutes of Health (NIH).

Keywords

maternal obesity

cesarean delivery

CD duration

BMI

neuraxial anesthesia

surgical factors

prior cesarean deliveries

general anesthesia

epidural blood patch

Mayo Clinic study