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根据体重指数对剖宫产孕妇的麻醉和产科结局:单中心经验的回顾性分析

Anesthetic and obstetric outcomes in pregnant women undergoing cesarean delivery according to body mass index: Retrospective analysis of a single-center experience.

作者信息

Riveros-Perez Efrain, McClendon Jacob, Xiong Jennifer, Cheriyan Thomas, Rocuts Alexander

机构信息

Department of Anesthesiology and Perioperative Medicine, Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA.

Outcomes Research Consortium, Cleveland Clinic, OH, USA.

出版信息

Ann Med Surg (Lond). 2018 Nov 2;36:129-134. doi: 10.1016/j.amsu.2018.10.023. eCollection 2018 Dec.

Abstract

AIM

To evaluate maternal, neonatal and anesthetic outcomes according to BMI in women undergoing cesarean section.

BACKGROUND

Increased incidence rates of obesity and morbid obesity have been reported in the United States. Pregnant obese patients are at increased risk of maternal and fetal complications, and obstetric and anesthetic management of these patients is especially challenging.

METHODS

A retrospective chart review of patients who underwent cesarean section in a single center between 2015 and 2016 was conducted. Anesthetic, obstetric and neonatal outcomes were analyzed in relation to levels of BMI.

RESULTS

Seven hundred and seventy one patients underwent cesarean section during the study period. The number of patients with normal BMI, obesity and morbid obesity was 213 (27.6%), 365 (47.3%) and 193 (25%), respectively. Sixty-one percent of the patients in morbidly obese group had at least one comorbidity (p < 0.01). We found no significant differences with respect to perioperative obstetric complications. Intraoperative blood loss was significantly higher in the morbidly obese group.

CONCLUSION

Increasing BMI is associated with comorbidities such as hypertension and diabetes mellitus, and with increased intraoperative blood loss. We were unable to detect differences in other obstetric, anesthetic and neonatal outcomes.

摘要

目的

根据体重指数(BMI)评估剖宫产女性的母体、新生儿及麻醉结局。

背景

据报道,美国肥胖和病态肥胖的发病率有所上升。肥胖孕妇发生母体和胎儿并发症的风险增加,对这些患者的产科和麻醉管理尤其具有挑战性。

方法

对2015年至2016年在单一中心接受剖宫产的患者进行回顾性病历审查。分析麻醉、产科和新生儿结局与BMI水平的关系。

结果

在研究期间,771例患者接受了剖宫产。BMI正常、肥胖和病态肥胖的患者人数分别为213例(27.6%)、365例(47.3%)和193例(25%)。病态肥胖组61%的患者至少有一种合并症(p<0.01)。我们发现围手术期产科并发症方面无显著差异。病态肥胖组术中失血量明显更高。

结论

BMI升高与高血压和糖尿病等合并症以及术中失血量增加有关。我们未发现其他产科、麻醉和新生儿结局存在差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca9e/6234280/fbb03f5ee41c/gr1.jpg

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