Maternal Obesity and Obstetric Anesthesia: A Comprehensive Review of Challenges and Clinical Strategies

Abstract

Background: Obesity in pregnancy is on the rise globally, posing additional physiological and logistical challenges to routine obstetric anesthesia practices. Such women display higher incidences of gestational diabetes, hypertensive disorders, and operative deliveries, indicating the urgency for tailored anesthetic strategies. Objectives: This review aims to synthesize current evidence on anesthetic approaches for obese parturients, focusing on the physiological implications of excess adipose tissue, neuraxial versus general anesthesia techniques, and optimal perioperative management to mitigate maternal and neonatal risks. Methods: A structured literature search was conducted on PubMed and Google Scholar to identify relevant peer-reviewed articles. After removing duplicates and screening abstracts, 20 studies met inclusion criteria. Data extraction centered on study design, participant BMI ranges, anesthesia techniques, and maternal-neonatal outcomes. Conclusion: Effective anesthetic care for obese parturients necessitates a multidisciplinary plan that includes early neuraxial analgesia, comprehensive airway preparation, and vigilant postoperative monitoring. By integrating best practices in pharmacologic dosing, ultrasound-guided epidural placement, and postoperative respiratory support, clinicians can significantly reduce morbidity and improve overall outcomes for this high-risk obstetric population.