Background Obesity is increasing in prevalence and maternal obesity confers high risk status. Focussed local efforts are needed in all care settings to ensure that a strategic framework is in place to enable effective delivery of care to this group of women to optimise outcomes. The East Lancashire Obesity project facilitated by a dedicated team has successfully achieved implementation of effective local services for obese pregnant women.

Aim To evaluate and monitor continuous quality improvement in ‘The Management of Maternal Obesity in Pregnancy’.

Method Retrospective review of 100 case records of obese pregnant women.

Results 100% compliance with height/weight/BMI measurement &documentation, and threefold increase in those receiving counselling on implications of condition were highlighted. (2009:5%, 2011:14%). Appropriate care pathway planning was noted in 100%. Hospital birth was appropriately planned in 92% and consultant antenatal review occurred in 77%. Offer &uptake of glucose tolerance test increased from 88% (2009) to 93%(2011). Referral & uptake of elective antenatal anaesthetic review was 94% and 81% respectively. There was 100% compliance with care plan recommendation for active 3rd stage management.

Conclusion/Recommendations Changes directed to improving care for obese women over the last few years through a dedicated group resulted in implementation of new guidelines, evidence based care pathway, supportive information leaflets, and dedicated clinics set up for anaesthetic review (BMI ≥40) which were contributory factors for this progress. Action plans through serial biannual clinical audits enabled demonstrable/sustainable improvement confirming that implementing change through audit process in Maternal Obesity in Pregnancy is certainly a feasible reality!