In 2012, a prospective 3-month audit of management of obesity in pregnancy was undertaken in Glasgow and Clyde maternity hospitals comparing practise to CMACE/RCOG guideline.1 214 women were identified out of 3,834 deliveries: 138 (64%) had a booking body mass index (BMI) of 35–39 whilst 76 (36%) had a BMI ≥ 40. Out of total deliveries, 3.5% had a BMI of 35–39 and 2.0% had a BMI ≥40.
43 (31%) women took folic acid preconception which increased to 125 (91%) women in first trimester. However, only 2 women took 5 mg preconception and 7 took this during first trimester. Only 4 women had documented evidence of vitamin D supplementation. Hand-held records were available in 197 cases and 193 (98%) women had booking BMI recorded. Anaesthetic review occurred in 68 (89%) women with BMI ≥ 40.
Antenatal thromboprophylaxis was indicated in 43 women, but 11 women received it. Postnatally, all women with BMI ≥ 40 should have thromboprophylaxis, however 50 (66%) received this, out of which 14 women received appropriate dose for weight. Though only 21 (10%) women had glucose tolerance test in BMI 35–39 group, this increased to 44 (58%) women in BMI ≥ 40 group.
44 (58%) women with BMI ≥ 40 had obstetric staff of specialty trainee year ≥6 in attendance at delivery. There is good compliance of guideline with 195 (91%) women having documented active management of third stage and only 1 woman induced for BMI. We conclude that some CMACE/RCOG recommendations have been implemented, though there is much scope for improvement.
Centre for Maternal and Child Enquires/Royal College of Obstetricians and Gynaecologists Joint Guideline. Management of women with obesity in pregnancy. March 2010.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.