Obesity GTG Flashcards
What % of antenatal are obese?
21%
Only 47% have BMI in normal range.
BMI Overweight?
> 25
BMI
Pre-obese
Obese Class 1
Obese Class 2
Obese Class 3
Pre-obese: 25-29.9
Obese Class 1 30-35
Obese Class 2 35-40
Obese Class 3 >40
Risk per 10,000 for severe morbidity and mortality in pregnancy for
Obese Class 1
Obese Class 2
Obese Class 3
Obese Class 1 25
Obese Class 2 35
Obese Class 3 60
How much more likely to suffer VTE in pregnancy if BMI >30?
9 times
How much more likely to suffer GDM in pregnancy if BMI >30?
3 times
How much more likely to suffer PIH-PET in pregnancy if BMI >30?
2-3 times
How much more likely to have C/S, stillbirth or PPH in pregnancy if BMI >30?
2 times
If BMI > 30 what additional care should be provided?
- Advice pre-pregnancy weight loss
- Folic acid 5mg 1 month before until end of 1st trimester
- Screen for GDM
- VTE 1 RF
- Active 3rd stage
- Specialist breast feeding support
- Offer nutritional advice post op
If BMI > 35 what additional care (including that of >BMI 30) should be provided?
- Deliver on consultant led unit
- Moderate PET RF (Give aspirin if Fhx, P0, Age >40, multiple preg)
- Serial USS
If BMI > 40 what additional care (including that of >BMI 30+35) should be provided?
- Moving and handling assessment
- AN anaesthetic review, inform anaesthetics when on LW
- Risk assessment 3rd trimester for tissue viability
- VTE 2 point
If obese and GDM, what is the increased risk for congenital abnormality?
3 fold
What is the success rate of IOL in obese women
i) For primip
ii) For multip
Primip: 60%
Multiple: 90%
What are the success rates for VBAC and IOL?
54%
BMI >40 increased risk uterine rupture
How long should someone wait after bariatric surgery before coming pregnant?
12-18 months
