Maternal Obesity Flashcards
When to start aspirin?
More than one moderate risk factor:
1st pregame
1- BMI 35 or more
2- age 40 years
3- family history of PET
4 intervals more than 10 years
5- multiple pregnancy
What are Maternal obesity risk intrapartum
1- PE, DVT
2- Miscarriage
3- GDM
4-PET
5- vitamin Ddeftiincy / anaemia
6- difficult monitoring FM
7- Depressions
8- pressure sore
Maternal obesity risk intrapartum
Difficult iv access ( early)
Difficult epidural and anaesthesia
Difficult Ctg
Difficult handling and transfer of pt
Prolonged 1st/ 2nd stage
Assisted delivery
Emergency section
PPH
Risk of maternal obesity postnatal
PPH,
Wound infection
Perpural sepsis
DVT, PE
Depression
Diabetes
Hypertension
Fetal obisty in child hood
Small size of BP cuff reading?
Increase BP reading by 10-40 might
Medicine to be given in obesity
Folic acid 5 mg until 12 weeks
Aspirin 150mg from 12 weeks
Vista
In D10 mcg OD
LMWH, measure peak anti Xa activity if Wight more than 90kg
Safety points in Labour if more than 40 BMI
Inform Anaesthesia dr
Early venous access
Alert Inform theatre
Bariatric bed in lLW
Active 3 rd stage management .
Handling risk team assessment in 3rd trimester
Documented risk assessment in her notes
Risk assessment in 3 rd trimester for Tissue viability issues
What are Fetal risk obesity ?
Congenital anomalies
Miscarriage
Neural tube defect
Macrosomic baby
PTL
Still birth 1: 100
Neonatal death
SGA if pt had bariatric surgery
USS challenges in obesity
Difficult to measure the much at translucency
Scan can be limited in screening for structural abnormalities
BMI more than 30 do serial growth scan
Serial SFH from 24 weeks
What measure will you do to avoid risk at CS in morbid obesity pt ?
Prophylactic ABX
Large transverse incision avoid anaerobic moist panniculus
Close skin with stable
What to do if impacted fetal head ?
Ask Anastasia to give glyceryl nitrate or salbutamol to stop contraction
Pushing method
Pull method breach extraction.
Fetal pillow.
