Pregnancy and Obesity

Obesity is increasingly common and has an impact on wide range of issues in pregnancy.

Nutritional counselling and tailor-made diet plan is important as they need quality nutrition and at the same time should not put on too much weight.
Obese women have a higher risk of preeclampsia and diabetes. They need to be screened for Glucose Intolerance / Diabetes and high BP.
The baseline BP should be recorded with the correct size of the cuff.
The prenatal test have lesser accuracy in the obese women.
The Invasive procedures (amniocentesis and CVS) are difficult to perform in the obese women. The risk of pregnancy loss after these procedures is higher in women with BMI > 40.
The ultrasound is done for assessing the anatomy. This is challenging as it is difficult to see fetus due to abdominal fat and therefore some abnormalities may be missed.
The labor may be difficult and prolonged as the fetus may be over weight too.
There are increased chances of requiring instrumental delivery (vacuum or forceps) and thereby increasing chances of pelvic floor injuries to the mother and traumatic injuries to the newborn babies.
There is increased risk of Emergency Caesarean Section due to obstructed labor.
Obesity and pregnancy are independent risk factors for venous thrombo-embolism. Therefore, patient may require prophylaxis in antenatal and post-partum period.
For contraception, the intrauterine devices are an excellent choice for the obese.
There are no medicines that can help weight loss except when one has diabetes or glucose intolerance.
Bariatric surgery may have a role in the morbidly obese.