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

Bassiony Dabian, Sameh Elmahdy, Akmal Elmazny, Bassem Mohammed, Ahmed Elzyat
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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 post-operative 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/m 2 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. [
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产妇肥胖对择期剖腹产手术和术后并发症的影响:一项观察性横断面研究
背景:大量研究表明,剖腹产术中和术后的困难可能与产妇肥胖有关。研究目的本研究旨在评估产妇肥胖对择期剖宫产术中和术后后遗症的影响。患者和方法:根据产妇分娩时的体重指数,将患者分为三组:正常体重、超重和肥胖产妇。记录手术数据,包括手术时间、CS 过程中的估计失血量等。术后数据包括拔除导管、肠鸣音恢复、活动、开始口服喂养等术后护理时间。术后并发症包括产后出血、手术部位感染、深静脉血栓、输血、入住重症监护室和肺栓塞。记录的胎儿结局包括 1 和 5 分钟 Apgar 评分、RDS、产伤、入住新生儿重症监护室。结果据统计,肥胖产妇的手术时间(40.30 ± 3.28 vs. 33.19 ± 4.42 vs. 27.80 ± 5.16 分钟)明显更长,需要插入腹腔引流管的比例更高(7.3%) vs. 0 (0.0%) vs. 0 (0.0%),移除导管的时间(5.48 ± 1.19 vs. 4.06 ± 0.82 vs. 3.00 ± 0.88 小时)更晚。与超重和正常体重的妇女相比,肥胖妇女产后出血的发生率在统计学上明显较高,分别为 16 (14.5%) vs. 12 (10.9%) vs. 6 (5.5%)。结论母亲或婴儿的不良后果与母亲肥胖有关。体重指数大于 30 kg/m 2 的产妇产后出血的风险较高,在手术室停留的时间较长,导尿管拔除时间较晚。在胎儿结局方面,胎儿巨大儿和新生儿一过性呼吸急促的风险与较高的体重指数有关。[
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