High BMI

Question 1

What is BMI:

Answer 1

-Measure of body fat against height
-can not tell difference between having fat and muscle
-high BMI is over 30

Question 2

Nutrition and pregnancy:

Answer 2

-NO ‘eating for two’
-only need an additional 200 calories in the last three months of pregnancy

Question 3

Why is good nutrition important during pregnancy?

Answer 3

-supports baby’s growth and maternal health
-reduces birth defects
-supports immune function and energy levels

Question 5

Folic acid during pregnancy

Answer 5

-40 units for 12 weeks
- 5mg if had baby with neural tube defects

Question 6

Antenatal care for women with high BMI (>40)

Answer 6

-discuss healthy eating and exercise
-refer to weight management programme
-discuss risks due to weight (GDM, VTE)
- GTT at 16 weeks and then at 28
-weekly BP monitoring
-serial scans

Question 7

Aspirin for pre-eclampsia risk

Answer 7

-150mgs from 12/40 to 36/40
-prev PET
-40+
-BMI over 35
-previously medicated hypertension

Question 8

When to commence antenatal enoxaparin?

Answer 8

28/40

Question 9

Risks of BMI >40 on maternal and neonatal outcomes:

Answer 9

-increased risk of stillbirth
-increased risk of IVD and CS
-increased PPH risk
-increased risk of wound infection
-increased NNU risk

Question 10

Intrapartum care for raised BMI:

Answer 10

-CTG
-presentation scan
-early IV access
-let anaesthetic team know on arrival

Question 11

Postnatal care for women with high BMI:

Answer 11

-enoxaparin for 6 weeks
-talk about contraception and pregnancy spacing