Obesity with Pregnancy

OBG-CLN-GUD-56-Vers.3.0 | Royal Hospital

1 - Introduction

1.1 Obesity is a complex multifactorial disease. In 2023, female obesity prevalence for Oman was 40.9 %.*[1] One third of women delivering in Royal Hospital are obese.*[2] Ob pregnancy is now one of the most important challenges in obstetric care.

1.2 Definition - Obesity is defined as the body mass index > 30.BMI is weight in kilograms divided by height in meters squared (kg/m2).

1.3 Complications for obese women during pregnancy:

Antenatal:

Intrapartum:

Postpartum

Miscarriage

More Induction of labour, prolonged labour and failure to progress

postpartum haemorrhage

Gestational diabetes

Higher Rate of instrumental delivery, caesarean section

Delayed wound healing

Pre-eclampsia

Shoulder dystocia

Increased rates of wound infection

Difficult screening for structural anomalies

Difficult foetal heart rate monitoring

Greater likelihood of needing support with breastfeeding establishment and continuation

Abnormalities in foetal growth

Difficulties with labour analgesia

Postnatal depression

Preterm labour.

Failure of TOLAC .

Long term neonatal consequences: infant weight gain, obesity

Thromboembolism events

Obstructive sleep apnoea

Carpal tunnel syndrome

Maternal death

Difficulties with labour analgesia / anaesthesia

General anaesthesia

  • Difficulty maintaining an adequate airway