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All subscribers to ACOG UPDATE audio CDs will also have free access and ability to download the same program in MP3 format. They can also download a PDF file of the complete transcript with Pre- and Post-test Questions and a List of Supplementary Reading Materials.

Volume 41, Issue 6
Publication date: December 1, 2015
Expiration date: December 1, 2018

Decision to Incision: Intrapartum Management of the Obese Patient
Haywood L. Brown, MD (Moderator)
F. Bayard Carter Professor and Chair of Obstetrics and Gynecology, Duke University School of Medicine, Durham, North Carolina

Chad A. Grotegut, MD
Associate Professor of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Duke University School of Medicine, Durham, North Carolina

Thomas S. Ivester, MD, MPH
Associate Professor of Maternal-Fetal Medicine; Medical Director for Quality and Safety in Obstetrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina

Learning Objectives
After completing this activity, the physician should be better able to:
1. Discuss theories for why obese women are at higher risk for dysfunctional labor and cesarean delivery.
2. Explain why inductions of labor are more common for women with a very high body mass index (BMI).
3. Describe anesthetic concerns and criteria for anesthesia consultation.
4. Identify key equipment needed and steps to take to prepare for labor.
5. Describe wound closure techniques and risk factors for surgical site complications.
6. Discuss special considerations for women undergoing cesarean after bariatric surgery.
7. Cite the success rate for women undergoing trial of labor after cesarean.


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