![]() ![]() The preferred method of prophylaxis is based on stratification by procedure type and duration, age, and presence of other VTE risk factors. Sequential compression devices (SCDs), low molecular weight (LMW) heparin, and low-dose unfractionated heparin (UFH) are options for VTE prevention. ![]() Obesity is an independent risk factor for venous thromboembolism (VTE). Perioperative management focuses on minimizing complications such as thromboembolism and infection. As in normal weight women, surgery should be performed utilizing the least invasive approach. Women with OSA are at increased risk for perioperative complications, such as oxygen desaturation, acute respiratory failure, post-operative cardiac events, and intensive care unit admission. Pre- and post-operative glycemic control improves outcomes in patients with diabetes. Women with risk factors for CAD (hypertension, diabetes, smoking, family history of CAD) should have a 12-lead electrocardiogram performed. A physical exam revealing a short, thick neck with limited range of motion can be indicative of a difficult intubation. Anesthesiologist consultation is appropriate when these conditions are suspected. ![]() Preoperative preparation for obese patients requires attention to health conditions more common with obesity, including coronary artery disease (CAD), hypertension, diabetes mellitus, and obstructive sleep apnea (OSA). Providers should be aware of the possibility to harbor implicit bias towards patients with obesity, work to identify any personal implicit bias, and address any identified biases to ensure it does not interfere with delivery of respectful care for patients with obesity. Surgical complications such as infection, venous thromboembolism (VTE), and wound complications are a major source of morbidity in obese women, but may be reduced with attention to preoperative, intraoperative and postoperative factors. ![]()
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