Intravenous anesthesia


Anesthesia and Pain Medicine. 2003 Dec. 7(4): 171-175
ⓒ Korean Society for Intravenous Anesthesia
Anesthetic Management of a Morbidly Obese Parturient with Fetal Macrosomia for Elective Cesarean Section -A case report-
Jong Won Lee, M.D., Serk Young Jeong, M.D., Mi Ae Cheong, M.D., and Kyo Sang Kim, M.D.
Department of Anesthesiology, College of Medicine, Hanyang University, Seoul, Korea

Pregnancy induces the pulmonary changes, such as reduced functional residual capacity and increased oxygen consumption. And obesity aggravates these changes markedly. Obesity is proved to be a major maternal high-risk factor. Some studies revealed that a perinatal loss in obese gravidae was ten times greater than that among non-obese gravidae, associated with increased risk of Cesarean section, and difficult airway management. Therfore an obese parturient can pose considerable physiological and technical challenge to the anesthesiologist. In general anesthesia, obese parturient have significant risk of difficult intubation, pulmonary aspiration of gastric contents, and hypoxia. A 31-yr-old morbidly obese parturient with a body mass index of 45.71 kg/m2 underwent an elective cesarean section under general anesthesia. Twenty five minutes after the start of the surgery, a male newborn weighing 6,160 g was delivered with an Apgar score 6 at 1 min and 9 at 5 min. Although SpO2 was decreased transiently after intubation, maternal and neonatal postpartum courses were uneventful. In conclusion, the elective Cesarean section in a morbidly obese parturient with fetal macrosomia was successfully managed with general anesthesia.
Key words : Cesarean section, gestational diabetes mellitus, macrosomia, maternal obesity
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