Fetus, obesity and pregnancy

Question 1

Definition of obesity

Answer 1

BMI > 30 at first antenatal appointment

Question 2

Risks

Answer 2

T2D, hypertension, cancer, PCOS, complications in pregnancy

Question 3

Cause

Answer 3

Calorie intake > expenditure

Medication, corticosteroid, underactive thyroid

Question 4

Maternal risks

Answer 4

GDM, preeclampsia, thromboembolism, PPH, wound infection

Question 5

What % of PP deaths were obese?

Answer 5

27%

Question 6

What is the relative risk of T2D after GDM?

Answer 6

7x

Question 7

Fetal risks

Answer 7

Miscarriage, congen abnorm, still birth, neonat death, prem, macrosoma, hypoglycaemia

Question 8

Child risk

Answer 8

Diabetes, CVD, cognitive and behavioural disorders

Question 9

Obesity in pregnancy is associated with?

Answer 9

Periph and hepatic insulin resistance
Increased metab fuel (gluc, lipids)
Inflam state 
Altered adipo function
Epigenetic changes

Question 10

How is it monitored in mother?

Answer 10

Self blood gluc monitoring

Question 11

How is it monitored in fetus?

Answer 11

Amniotic fluid insulin and fetal AC to measure growth

Question 12

Management before pregnancy?

Answer 12

Inform about risks
5mg folic acid daily
Help women lose weight

Question 13

During pregnancy

Answer 13

Don't diet
LGI and high fibre diet with moderate exercise
Vit D supp
Birth/anaesthetic plan in place 
Thromoboprophylaxis risk assessment
Active management of labour