Title: Impact of Obesity on Incision to Delivery Time and Total Operative Time at Cesarean Delivery
Authors: Tejas.S.V., Savitha.C.
DOI: https://dx.doi.org/10.18535/jmscr/v5i7.42
Abstract
Objective: To examine the relationship between body mass index (BMI, kg/m2) and incision-to-delivery interval and total operative time at cesarean delivery.
Methods: This was a prospective study of women with singleton gestations undergoing primary and repeat cesarean deliveries in Department of OBG, BMCR&I, BANGALORE from DEC 2014 to MAY 2016 were studied. Women were classified by BMI category (prepregnant weight) at time of delivery (normal 18.5-24.9, overweight 25.0-29.9, obese 30.0-39.9, and morbidly obese 40 or greater). Incision-to-delivery interval and total operative times during cesarean delivery were compared between obese and non obese.
Results: Of the 150 women included in the analysis, 75 were non-obese (50%) and 75 (50%) were obese. Longer operative times and incision-to-delivery interval were found among women as BMI increases. normal BMI(mean [standard deviation] incision-to-delivery: 4.8 [1.29] and total operative time: 34.1 [7.61] minutes), overweight (5.0 [1.36]; 36.79 [9.73] minutes), and obese BMIs (8.24 [2.2]; 52.0 [22.0] minutes) compared with women with non obese BMI at delivery (4.84 [1.29]; 34.6 [13.0] minutes) (P<.001).
Conclusion: Increasing BMI is related to increased incision-to-delivery interval and total operative time at cesarean delivery with morbidly obese BMI exposing fetus to the risk of prolonged incision-to-delivery interval and exposing women to the risk of longer operative times.
Keywords: Cesarean Delivery, Obesity, Incision To Delivery Interval.
References
1. Myles TD, Gooch J, Santolaya J. Obesity as an independent risk factor for infectious morbidity in patients who undergo cesarean delivery. Obstet Gynecol 2002;100:959–64.
2. Perlow JH, Morgan MA. Massive maternal obesity and perioperative cesarean morbidity. Am J Obstet Gynecol 1994;170:560–5.
3. Butwick A, Carvalho B, Danial C, Riley E. Retrospective analysis of anesthetic interventions for obese patients undergoing elective cesarean delivery. J Clin Anesth. 2010;22:519–526.
4. Conner SN, Tuuli MG, Longman RE, Odibo AO, Macones GA, Cahill AG. Impact of obesity on incision-to-delivery interval and neonatal outcomes at cesarean delivery. Am J Obstet Gynecol. 2013;209:386.e1–386.e6.
5. Doherty DA, Magann EF, Chauhan SP, O’Boyle AL, Busch JM, Morrison JC. Factors affecting caesarean operative time and the effect of operative time on pregnancy outcomes. Aust N Z J Obstet Gynaecol. 2008;48:286–291.
6. Rossouw JN, Hall D, Harvey J. Time between skin incision and delivery during cesarean. Int J Gynaecol Obstet. 2013;121:82–85.
7. Hood DD, Dewan DM. Anesthetic and obstetric outcome in morbidly obese parturients. Anesthesiology. 1993;79:1210–1218.
8. Robinson HE, O’Connell CM, Joseph KS, McLeod NL. Maternal outcomes in preg-nancies complicated by obesity. Obstet Gynecol. 2005;106:1357–1364.
9. Conner SN, Verticchio JC, Tuuli MG, Odibo AO, Macones GA, Cahill AG. Maternal obesity and risk of post-cesarean wound complications. Am J Perinatol. 2014;31:299–304.
10. Edwards RK, Cantu J, Cliver S, Biggio JR, Jr, Owen J, Tita AT. The association of maternal obesity with fetal pH and base deficit at cesarean delivery. Obstet Gynecol. 2013;122:262–267.