The effect of maternal obesity on labour and labour pain.
Consecutive obese (n = 53) and non-obese parturients (n = 609) were prospectively evaluated during labour to analyse the influence of maternal obesity on labour pain and outcome. Excessive pre-pregnancy weight was classified as a body mass index of 30 kg.m-2 or more. Pain intensity was measured using an 11 point visual scoring scale. Obese parturients had more complicated pregnancies (hypertension and diabetes) and their babies weighed significantly more (3865 g versus 3592 g, p < 0.001). These differences did not affect labour pain experience, or the duration or mode of delivery. Eighty-five percent of the obese parturients and 83% of the controls had high maximal pain scores during the first stage (> 7). Both groups received similar analgesia. More technical problems (p = 0.03) were experienced in establishing epidural analgesia for obese parturients, but this did not influence the success of pain treatment. After delivery, obese women were significantly more content with the pain relief received; only 12% vs 23% in the control group complained of poor pain control (p = 0.03). In this study, obesity and increased fetal size did not complicate labour or its outcome. Critical patient assessment should be emphasised, however, due to the physiological and medical problems present in obese parturients.
Ranta
P
P
Department of Anaesthesiology, Oulu University Central Hospital, Finland.
Jouppila
P
P
Spalding
M
M
Jouppila
R
R
D000328:Adult; D016362:Analgesia, Obstetrical / Q000379:methods*; D036861:Delivery, Obstetric / Q000379:methods; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric / Q000502:physiology*; D009407:Nerve Block; D009765:Obesity / Q000150:complications / Q000503:physiopathology*; D059408:Pain Management; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D013997:Time Factors