Effect of Maternal Obesity on Operative and Post-Operative Complications of Elective Cesarean Section: An Observational Cross-Sectional Study

Abstract

Background: Numerous studies indicate that difficulties during and after cesarean section may be linked to maternal obesity.

Objective: This study aimed to assess the consequences of maternal obesity on intra-operative and postoperative sequelae of elective Cesarean delivery.

Patients and methods: Based on maternal BMI at time of delivery, patients were categorized into 3 groups: Normal weight, overweight  and obese women. Operative data were documented including operative time, estimated blood loss during CS, etc. Post-operative data  included post-operative care timing of catheter removal, return of intestinal sounds, mobilization, initiation of oral feeding, etc. Post- operative complications included postpartum hemorrhage, surgical site infection, DVT, blood transfusion, ICU admission and pulmonary  embolism. Fetal outcome was documented including 1 & 5 minute Apgar score, RDS, birth injuries, NICU admission.

Results: Operative  time was statistically significant longer 40.30 ± 3.28 vs. 33.19 ± 4.42 vs. 27.80 ± 5.16 mins, need insertion of intra- peritoneal drain was higher (7.3%) vs. 0 (0.0%) vs. 0 (0.0%), timing of catheter removal was more delayed 5.48 ± 1.19 vs. 4.06 ± 0.82 vs. 3.00  ± 0.88 hours among obese. Incidence of postpartum hemorrhage was statistically significant higher 16 (14.5%) vs. 12 (10.9%) vs. 6 (5.5%) among obese compared to overweight and normal weight women.

Conclusion: Adverse consequences for either mother or baby  have been linked to maternal obesity. BMI > 30 kg/m2 was linked to a higher risk of postpartum hemorrhage, a longer length of stay in  the operating room, and delayed urinary catheter removal as maternal outcomes. In terms of fetal outcomes, a greater risk of fetal  macrosomia and the newborn's transient tachypnea were linked to higher BMI.