Cesarean delivery is a frequent occurrence among pregnant obese women and requires careful perioperative planning to ensure optimal maternal and newborn outcomes [1,2]. The risks and challenges of the procedure increase as the severity of obesity increases.
The following body mass index (BMI) classifications for obesity were adopted by the National Institute of Health (NIH) and World Health Organization (WHO) and have been endorsed by most expert groups [3,4]. For whites, Hispanics, and blacks:
- Class I obesity — BMI of 30.0 to 34.9 kg/m2
- Class II obesity — BMI of 35.0 to 39.9 kg/m2
- Class III obesity — BMI ≥40 kg/m2 (also called severe, morbid, or extreme obesity)
Although the WHO identified additional trigger points for intervention and public health policy for Asians, obesity continues to be defined as a BMI >30 kg/m2 in this population .
Issues specifically relating to cesarean delivery in the obese woman will be discussed here. General issues relating to cesarean delivery, the numerous maternal and perinatal risks of obesity during pregnancy and the immediate postpartum period, and anesthesia and surgery issues in obese individuals are reviewed separately: