[2] Obesity In Pregnancy Flashcards

1
Q

What are the potential complications of obesity in the first trimester?

A
  • VTE
  • Miscarriage
  • Fetal abnormality
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2
Q

What fetal abnormalities are especially common in the first trimester due to obesity in pregnancy?

A

Neural tube defects

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3
Q

What are the potential complications of obesity in pregnancy in the second trimester?

A
  • Pre-eclampsia
  • Gestational diabetes
  • VTE
  • Macrosomia
  • Stillbirth
  • Difficulty with fetal assessment
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4
Q

What difficulties can occur in fetal assessment due to obesity in pregnancy?

A

Maternal adiposity can impact the ability to accurately describe fetal size clinically and using ultrasound

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5
Q

What are the potential effects of obesity in pregnancy on labour?

A
  • Need for induction

- Poor progress of labour

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6
Q

What are the potential effects of obesity in pregnancy on delivery?

A
  • Need for instrumental or C-section
  • Anaesthetic complications
  • Shoulder dystocia and extended perineal tears
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7
Q

How do the rates of C-section in obesity in pregnancy compare to normal women?

A

Higher

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8
Q

What is thought to cause the higher rates of c-section in obesity in pregnancy?

A
  • Fetal macrosomia
  • Co-morbid conditions
  • Hormonal effect of adipose tissue
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9
Q

What are the potential anaesthetic complications caused by obesity in pregnancy?

A
  • Difficult intubation

- Difficult epidural insertion

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10
Q

What are the potential effects of obesity in the post-natal period?

A
  • Postpartum haemorrhage
  • VTE
  • Neonatal death or need for admission
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11
Q

What are the potential long term effects of obesity in pregnancy?

A
  • Childhood obesity

- Juvenile diabetes

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12
Q

How can obesity in pregnancy ideally be avoided?

A

Pre-conceptual counselling to allow women to achieve a nearer to normal weight before conception

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13
Q

How often do women lose weight before conception?

A

Rarely

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14
Q

Where should women who have obesity in pregnancy be managed?

A

In hospital

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15
Q

What should be the aim of women with obesity in pregnancy?

A

Achieve a healthier diet rather than lose weight

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16
Q

How long should folic acid be taken for in obesity in pregnancy?

A

Until 12 weeks

17
Q

What other conditions should women who have obesity in pregnancy be assess for their risk of?

A
  • VTE

- Pre-eclampsia

18
Q

What may be given to reduce the risk of VTE in obesity in pregnancy?

A

Aspirin

19
Q

What should be offered in the late 2nd trimester for women with obesity in pregnancy?

A

GTT

20
Q

Where should women with obesity in pregnancy give birth?

A

In hospital

21
Q

How should women with obesity in pregnancy deliver?

A

Vaginally unless contra-indicated