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Page 45
Volume 05
Journal of Clinical Nutrition & Dietetics
ISSN: 2472-1921
JOINT EVENT
June 17-18, 2019 London, UK
Nutrition World 2019
Euro Obesity 2019
June 17-18, 2019
&
26
th
World Nutrition Congress
15
th
Euro Obesity and Endocrinology Congress
Cesarean section in extremely obese parturients
Michael Stark
New European Surgical Academy, Germany
O
besity is associated with increased risk of adverse pregnancy outcomes. At the time where Cesarean section is
the most frequent operation worldwide. Once in a while it is indicated for obese parturient and needless to say
that obesity is associated with other maternal as well as fetal metabolic risks. There is a direct correlation between
surgical steps and their influence on post-surgical pain. Therefore, every single step in each operation should be
based on studies comparing different methods considering the outcome. Different surgeons perform operations
with the same indication in different ways. The lack of standardization does not enable comparison and certainly not
meta-analysis. This was the reason why we started to evaluate the outcome of single steps and their combinations
on the post-operative pain as well as on the mobility and well-being of the parturient. Among our parturients were
19 women with BMI 38-41. The modified Joel-Cohen method proved not just to reduce febrile morbidity, but to
have direct influence on post-operative pain. A direct correlation was found between the outcome of operations
where the uterus was closed with one or two layers, closing peritoneum or leaving it open as well as the different
suture material and the needles size. Amazingly it was shown that the higher the BMI, the less blood loss from the
abdominal wall when using this technique and less stitches were needed to close the skin. There was no difference
concerning febrile morbidity, mobility after the surgery or the use of analgesics compared to women with normal
BMI. Without exception, scores of studies showed that following these steps the post-operative pain and the need
for analgesics are significantly reduced.
mstark@nesacademy.orgJ Clin Nutr Diet 2019, Volume 05