Intrapartum care for obese women

40.1

Introduction

• The prevalence of obesity in high-resource countries is rising in all age groups.

• It is estimated that over a third of women in the reproductive age are obese.

• Obesity is both a metabolic and an inflammatory disorder.

• Obesity is defined as a body mass index (BMI) of 30 or above, and the following classification is used in this chapter:

  • o

    class I: BMI 30.0–34.9.

  • o

    class II: BMI 35.0–39.9.

  • o

    class III or morbid obesity: BMI ≥ 40.0.

• Obesity carries with it a higher risk of adverse pregnancy outcomes, and this risk increases with the severity of obesity.

• Obese women often present with comorbidities, which ultimately amplify the risk of maternal and perinatal complications.

• Labour progress is slower in obese women and intrapartum care is often more challenging. This does not mean that obesity is an indication for caesarean delivery.

• Planning and a multidisciplinary approach are required for an adequate surveillance of pregnancy and delivery in obese women.