Pregnancy: obesity Flashcards
Pregnancy: obesity
Obese women, and their unborn children, are at an increased risk of a number of complications during pregnancy and labour. Obesity is usually defined as a body mass index (BMI) >= 30 kg/m² at the first antenatal visit.
Maternal risks
miscarriage
venous thromboembolism
gestational diabetes
pre-eclampsia
dysfunctional labour, induced labour
postpartum haemorrhage
wound infections
There is also a higher caesarean section rate.
Fetal risks
congenital anomaly
prematurity
macrosomia
stillbirth
increased risk of developing obesity and metabolic disorders in childhood
neonatal death
With respect to weight loss, NICE state:
Explain to women with a BMI of 30 or more at the booking appointment how this poses a risk, both to their health and the health of the unborn child. Explain that they should not try to reduce this risk by dieting while pregnant and that the risk will be managed by the health professionals caring for them during their pregnancy
Management
obese women should take 5mg of folic acid, rather than 400mcg
all obese women should be screened for gestational diabetes with an oral glucose tolerance test (OGTT) at 24-28 weeks
if the BMI >= 35 kg/m² women should give birth in a consultant-led obstetric unit
if the BMI >= 40 kg/m² should have an antenatal consultation with an obstetric anaesthetist and a plan made
