[2] Obesity In Pregnancy Flashcards
What are the potential complications of obesity in the first trimester?
- VTE
- Miscarriage
- Fetal abnormality
What fetal abnormalities are especially common in the first trimester due to obesity in pregnancy?
Neural tube defects
What are the potential complications of obesity in pregnancy in the second trimester?
- Pre-eclampsia
- Gestational diabetes
- VTE
- Macrosomia
- Stillbirth
- Difficulty with fetal assessment
What difficulties can occur in fetal assessment due to obesity in pregnancy?
Maternal adiposity can impact the ability to accurately describe fetal size clinically and using ultrasound
What are the potential effects of obesity in pregnancy on labour?
- Need for induction
- Poor progress of labour
What are the potential effects of obesity in pregnancy on delivery?
- Need for instrumental or C-section
- Anaesthetic complications
- Shoulder dystocia and extended perineal tears
How do the rates of C-section in obesity in pregnancy compare to normal women?
Higher
What is thought to cause the higher rates of c-section in obesity in pregnancy?
- Fetal macrosomia
- Co-morbid conditions
- Hormonal effect of adipose tissue
What are the potential anaesthetic complications caused by obesity in pregnancy?
- Difficult intubation
- Difficult epidural insertion
What are the potential effects of obesity in the post-natal period?
- Postpartum haemorrhage
- VTE
- Neonatal death or need for admission
What are the potential long term effects of obesity in pregnancy?
- Childhood obesity
- Juvenile diabetes
How can obesity in pregnancy ideally be avoided?
Pre-conceptual counselling to allow women to achieve a nearer to normal weight before conception
How often do women lose weight before conception?
Rarely
Where should women who have obesity in pregnancy be managed?
In hospital
What should be the aim of women with obesity in pregnancy?
Achieve a healthier diet rather than lose weight
How long should folic acid be taken for in obesity in pregnancy?
Until 12 weeks
What other conditions should women who have obesity in pregnancy be assess for their risk of?
- VTE
- Pre-eclampsia
What may be given to reduce the risk of VTE in obesity in pregnancy?
Aspirin
What should be offered in the late 2nd trimester for women with obesity in pregnancy?
GTT
Where should women with obesity in pregnancy give birth?
In hospital
How should women with obesity in pregnancy deliver?
Vaginally unless contra-indicated
