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. 2011 Oct;205(4):370.e1-6.
doi: 10.1016/j.ajog.2011.06.085. Epub 2011 Jun 29.

Impact of morbid obesity on epidural anesthesia complications in labor

Laura K Vricella  1 , Judette M Louis, Brian M Mercer, Norman Bolden
Affiliations

Impact of morbid obesity on epidural anesthesia complications in labor

Laura K Vricella et al. Am J Obstet Gynecol. 2011 Oct.

Abstract

Objective: We sought to determine whether morbid obesity is associated with increased maternal hypotension or fetal heart rate (FHR) abnormalities after epidural anesthesia placement during labor.

Study design: This was a retrospective cohort study of women undergoing epidural anesthesia during labor at term from April 2008 through July 2010.

Results: A total of 125 morbidly obese patients were matched for age and race with 125 normal-weight patients. Morbidly obese patients had more frequent persistent systolic (16% vs 4%, P = .003) and diastolic (49% vs 29%, P = .002) hypotension and more prolonged (16% vs 5%, P = .006) and late (26% vs 14%, P = .03) FHR decelerations. Increasing body mass index was associated with persistent systolic (odds ratio, 1.06; 95% confidence interval, 1.02-1.10) and diastolic (odds ratio, 1.04; 95% confidence interval, 1.01-1.06) hypotension after controlling for epidural bolus dose and hypertensive disorders.

Conclusion: Morbidly obese women have more hypotension and prolonged FHR decelerations following epidural anesthesia during labor at term.

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