The management of a super morbidly obese parturient delivering twins by caesarean section.

A super morbidly obese (230 kg, body mass index 76 kg/m2) patient presented to our service for a planned elective caesarean section for twin delivery. She subsequently underwent a non-elective caesarean section after normal working hours under combined spinal epidural anaesthesia with invasive monitoring. Complex cases such as this, especially in the obstetric setting, require thorough multidisciplinary planning, communication and expertise but can be safely and successfully performed in dedicated stand-alone centres.