Caesarean section associated with gross obesity.

The anaesthetic and surgical problems associated with Caesarean section in eight grossly obese patients (weight 150-204 kg) are described. In addition to an increase in the frequency and severity of the complications of obesity, those weighing more than 150 kg present a panniculus which may weigh 70 kg. Extradural analgesia was used for three patients and general anaesthesia for five (two because of fetal distress). One fetus died in utero after serious and prolonged arterial hypotension in the mother caused by powerful cephalad retraction of the panniculus (extradural analgesia). General anaesthesia was associated with severe episodes of hypertension in two patients.