Obesity in Pregnancy and Surgical Techniques

Background: Obesity has become a modern world pandemic. It causes increased morbidity in the postoperative period. Postoperative wound infection being one of the major contributing factors. Materials and Methods: Ours is a prospective cohort study done at Fernandez Hospital, Hyderabad, a tertiary care hospital from June 2022 to July 2023. We compared high transverse skin incisions and pfannenstielincisions in obese women undergoing caesarean section. There were 436 women in the pfannenstiel incision group and 145 women in the high transverse incision group. Two groups were compared for the outcomes of wound infection, baby delivery time, blood loss, duration of surgery, APGAR score at 5 minutes, NICU admissions, wound discharge, postoperative hospital stay and postnatal admissions. Results: The baby delivery time, duration of surgery, and blood loss were higher in the High transverse incision group. There were no significant differences between the APGAR score at 5 min and NICU admissions between the two groups. The incidence of wound infection was higher in the pfannenstiel incision group compared to the high transverse incision group.However, the difference did not reach a statistically significant level. Conclusion: High transverse incision can be considered to reduce wound infections in obese women with BMI >35, based on the grading of pannus.