Anesthetic management of abdominal delivery in pregnant women with morbid obesity

Objective — to analyze current data on anesthetic management techniques for abdominal delivery in pregnant women with morbid obesity. The review was conducted by searching PubMed, Google Scholar, and eLibrary databases from January 1, 2000, to August 31, 2024, using the keywords: pregnancy, obesity, body mass index, cesarean section, anesthesia, and complications. The search yielded 724 references. 655 references were excluded from the review due to their description of pregnancy management and spontaneous labor in obese patients. The literature review included 69 references. Inclusion criteria: design (clinical studies in all peer-reviewed journals without language or national restrictions); subjects (pregnant women with obesity grade II or higher). This review examines anesthesia techniques for cesarean section in pregnant women depending on the severity of obesity. The analysis revealed a wide range of neuraxial and general anesthesia techniques, each with its own advantages and disadvantages, and none is “perfect.” Anesthetic management of abdominal delivery in pregnant and postpartum women with morbid obesity requires a personalized, multidisciplinary approach. The review data suggest that further research is needed to personalize anesthesia for cesarean section in obese patients.