• Laurence E Ring.
• Division of Obstetric Anesthesiology, Department of Anesthesiology, Columbia University Medical Center/New York Presbyterian Hospital, 630 W 168th St, Room 12-402, New York, NY 10032. Electronic address: ler20@cumc.columbia.edu.
• Semin. Perinatol. 2014 Oct 1; 38 (6): 341-8.

AbstractExtreme obesity (BMI ≥ 40) is thought to complicate approximately 5% of deliveries in the United States. Extreme obesity puts a pregnant woman at an increased risk for cardiovascular disease, including hypertension, coronary artery disease, and congestive heart failure; respiratory disease, including obstructive sleep apnea and asthma; as well as pregnancy-specific diseases including pregnancy-induced hypertension and gestational diabetes. Extreme obesity also puts a parturient at a significantly increased risk of requiring cesarean delivery. For the anesthesiologist, the physiologic changes of obesity combined with the normal physiologic changes of pregnancy can make for a complex and challenging case. This review will focus on the anesthetic approach to the extremely obese parturient undergoing scheduled operative delivery. With proper planning and a detailed understanding of the patient's comorbidities, a safe and effective anesthetic can be achieved.Copyright © 2014 Elsevier Inc. All rights reserved.

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