الفهرس 
ObesityOnly 14 pages are availabe for public view
 |  | from | 32 |  |  |
| | | from | 32 | | |
Abstract
Obesity has been recognized by WHO as ”a pandemic nutritional disorder which represents a rapidly growing threat to the health of populations of an increasing number of countries world wide”. As obesity increases, so does the number of women of reproductive age who are overweight and obese. The problems relating to the management of obesity in pregnancy are many. There are both short-and long-term complications and implications for both mother and fetus.
The obstetric complications of maternal obesity are generally related to issues of maternal pre-gravid obesity rather than excessive weight gain during gestation that results in a non-obese women becoming obese. Many studies have demonstrated that obesity in pregnancy is associated with a wide spectrum of adverse pregnancy outcomes including increased caesarean section rates, postpartum haemorrhage, higher risks of maternal hypertension and gestational diabetes and fetal death.. Obesity in pregnancy has also been shown to be associated with longer gestation\ and significantly increased risk of post-term delivery which contributes to the greater need for induction of labour (IOL) for prolonged pregnancy. As gestation progresses beyond term, perinatal morbidity and mortality increase as well as maternal complications such as pre-eclampsia, postpartum haemorrhage and caesarean delivery. Women with high body mass index (BMI) and prolonged pregnancy are therefore becoming an increasingly prevalent clinical problem.
In this study two hundred and fifty (250) pregnant women were included, they were divided into 2 groups:
(1) group A: normal weight (BMI = 18 – 24.9 kg/m2).
(2) group B: overweight (BMI = or >30 kg/m2).
The influence of obesity on maternal and neonatal outcomes was compared between the 2 groups regarding mode of delivery, reason for delivery mode, labour length (first, second, third stage), estimated blood loss, the extent of perineal trauma including second and third degree tears, Apgar score at1min & 5min after delivery and incidence of macrosomia, shoulder dystocia and stillbirth
The principal aim of this study was to examine pregnancy outcomes (As regard the mode of delivery and augmentation of labor) in obese women. Our study found increased risk of several complications in obese women; like increased rate of CS as 47.2% of obese women delivered by CS compared to 24.8% of normal weight women, need for augmentation of labor as 40% of obese women need augmentation while 24.8% of non obese women need augmentation, increase rate of perineal tears as 30.3% of obese patients had perineal tears while only 6.38% of normal weight women had perineal tears, fetal macrosomia as 25.6% of obese women had fetal macrosomia while only 4.8% of normal weight women had fetal macrosomia, low APGAR score (P=0.019), increase incidence of shoulder dystocia as 10.4% of obese women had shoulder dystocia during delivery while only 1.6% of non obese women had shoulder dystocia, increase incidence of admission to NICU as 8% of newborn of obese women were admitted to NICU while 3.2% of newborn of non obese women were admitted to NICU.
This study, like any other observational study of its kind suffers from several limitations. Firstly, Weight and height were measured at time of delivery; pre-pregnancy measurements were not available. However the ideal time to record the baseline height and weight of a pregnant woman is before she has started gaining weight due to gestation taking into consideration that pre-pregnancy weight was known from the patients own words and history taking. The second limitation was the lack of standard definitions of overweight and obesity which makes comparison of findings across studies difficult.
The primary objective in the management of obesity during pregnancy is prevention, having obese women lose weight with lifestyle changes and achieve a normal BMI before conception would be the ideal goal.