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Women with BMI over 35, aspects of care and obstetric outcomes
  1. LJ Doherty,
  2. D Chandranath,
  3. A Zawislak
  1. Royal Jubilee Maternity Hospital, Belfast, UK

Abstract

Introduction The risk of maternal and fetal morbidity and mortality is well recognised in pregnancies complicated by obesity. Work is currently ongoing by CEMACE (Centre for Maternal and Child Enquiries (CHACE) formerly known as CEMACH) and Royal College of Obstetricians and Gynaecologiststo devise guidelines and auditable standards to minimise this risk.

Method In August and September 2009 60 women delivered who had body mass index (BMI) over 35 at booking. 30 charts were available for review.

Results Average age was 29. BMI ranged from 35 to 51. The majority of booking appointments took place 11–14 weeks. Average number of antenatal visits was five. 53% required repeat booking and/or anomaly scan due to imaging difficulties. Rate of induction of labour (IOL) 33%, C/S 43% (4/13 emergency), operative vaginal delivery 3%. One infant required neonatal unit (NNU) admission. 43% had postnatal thromboprophylaxis with enoxaparin. 23% had counselling regarding future pregnancies.

Discussion The rate of intervention is higher in women with raised BMI, technical difficulties associated with these interventions further increase risk. Caesarean section rates were above average but IOL rate comparable to the general population. Increased demand on antenatal services was demonstrated.

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