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EP016 Neuraxial techniques for the obese parturient: our experience from the labor room
  1. Aliki Tympa-Grigoriadou,
  2. Christina Orfanou,
  3. Marianna Kourousi,
  4. Thalis Asimakopoulos,
  5. Georgios Vaiopoulos,
  6. Aikaterini Melemeni and
  7. Athanasia Tsaroucha
  1. st Department of Anesthesiology, School of Medicine, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece


Background and Aims Obese parturients are frequently encountered in the maternity wards and this population is expected to increase, in accordance with the obesity prevalence in the general population. Anesthetists may confront difficulties mainly regarding airway management and neuraxial techniques.

Methods Parturients with a BMI>30kg/m2 at the time of labor were retrospectively identified, form January 2022 to January 2023. Data was collected from patient record and details of anesthetic management and obstetric complications were recorded, after Ethics Committee approval was granted.

Results 106 obese parturients identified during the aforementioned period. The mean BMI was 34.7kg/m2, ranging from 30.1 to 49.4 kg/m2. 92 (86.7%) of them received an intrapartum neuraxial technique. 90 (89.5%) of them had an unassisted vaginal delivery, 16 (15%) an operative or instrumental delivery and 27 (25.4%) cesarean delivery (7 as emergency). Overall, 92 (86.7%) obese parturients received a labor epidural or a dural puncture epidural. 3 women requested labor epidural, but that was not achieved. 5 labor epidural attempts were recorded as vigorous. Regarding cesarian sections, 25 (92%) were performed under regional anesthesia (new spinal/combined spinal epidural anesthesia or successful top-up of the labor epidural) and 2 (7%) under general anesthesia. 44 deliveries (41.5%) were completed out of hours, while another 15 lasted for over 12 hours.

Abstract EP016 Table 1

Grade of cesarean section in relation with parturient BMI and anesthetic technique

Abstract EP016 Figure 1

Body mass index (BMI) of the obese parturients of the labor room of Aretaieion University Hospital during the period January 2022 – January 2023

Abstract EP016 Figure 2

Anesthetic technique for cesarean section

Conclusions Obese obstetric population frequently requires regional anesthetic care, while clinical pressures demand highly skilled senior anesthetists. Out of hours deliveries and long-lasting labors are common. Thus, antenatal anesthetic assessment, antenatal counseling and senior involvement is considered very important.

  • Obesity
  • Parturient
  • Labor room
  • Regional anesthesia
  • Labor epidural

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