title: Anaesthetic outcomes in obese parturients: the effect of assessment in the high-risk clinic.
abstract: BACKGROUND
  Obese parturients are at high risk of complications during anaesthesia and early use of epidural analgesia in labour has been recommended for obese patients during labour.
  
  
  OBJECTIVE
  To assess the outcome of anaesthesia outpatient consultation for obese parturients.
  
  
  METHODS
  We retrospectively compared outcomes of obese patients antenatally and an obese and non-obese control group over a 1-year period. Outcomes included potential airway problems, anaesthetic for caesarean section, use and success of epidural analgesia and cervical dilation at epidural placement.
  
  
  RESULTS
  The proportion of obese patients who had predictable intubation difficulty was low (5%). Epidural use analgesia in labour (69 vs 36 vs 66%, P = 0.148) was similar between groups (obese, obese controls and non-obese controls, respectively). Cervical dilation at the time of epidural insertion in the obese group (2.0, 1.0-3.0 cm) was not different from obese controls (3.0, 1.75-5.75 cm). There was no difference in the number of attempts required to site the epidural between groups or the number of patients that required resiting of the epidural catheter. General anaesthesia was not required in any emergency case in this group.
  
  
  CONCLUSIONS
  The outcomes of obese patients attending the anaesthetic clinic were mixed. Not all patients who were to advised have epidurals did so but those who did requested them in early labour and there was no requirement for general anaesthesia during emergency caesarean section and adverse airway events were avoided in this group.
authors.affiliation: Department of Anaesthesia, The Rotunda Hospital, Parnell Square, Dublin, Ireland.
authors.forename: A
authors.initials: A
authors.lastname: Aslani
authors.forename: V
authors.initials: V
authors.lastname: Husarova
authors.forename: P
authors.initials: P
authors.lastname: Ecimovic
authors.forename: J
authors.initials: J
authors.lastname: Loughrey
authors.forename: C
authors.initials: C
authors.lastname: McCaul
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000009:adverse effects*; D037001:Directive Counseling; D005260:Female; D006801:Humans; D009765:Obesity / Q000150:complications*; D007744:Obstetric Labor Complications / Q000209:etiology / Q000517:prevention & control*; D011247:Pregnancy; D011295:Prenatal Care; D012189:Retrospective Studies; D018570:Risk Assessment; D055815:Young Adult