1. Obesity and Pregnancy An everyday event
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Obesity and Pregnancy An everyday event
Kimberly Farry MD October 2017

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Objectives:
Impact of obesity on female reproduction, pregnancy and the fetus
Equipment considerations for the extreme obese

4. What is the scope of the problem?
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What is the scope of the problem?

5. What is obesity?

6. BMI provides the most useful population-level measure of overweight and obesity as it is the same for both sexes and for all ages of adults. (WHO)
Obesity is a medical condition in which excess body fat has accumulated to the extent that It may have a negative effect on health. (Wickipedia)
WORLD: In 2016, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 650 million were obese. 39% of adults aged 18 years and over were overweight in 2016, and 13% were obese. (WHO)
WV: As of August, 2017, 37.7% of adults are obese. #1/51 (State of obesity.org)

7. In WV 56.3% of all pregnant women in 2016 were overweight or obese.

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Why is this important?
Sometimes the smallest things take up the most room in your heart……
Winnie the Pooh

9. Pre-pregnancy:. Increased Medical problems. Infertility. PCOS
Pre-pregnancy: Increased Medical problems Infertility PCOS Hypertension Diabetes Depression/ Anxiety Increased spontaneous abortion and recurrent miscarriage

10. Pregnancy: Congenital anomalies (especially NT defects)
Decreased ultrasound detection
Depression and Anxiety
Sleep apnea
GDM
PIH/ Preeclampsia
Fetal growth abnormalities – both small and large
Preterm labor both spontaneous and induced for medical indications
Prolonged Pregnancy (Increased Induction)
IUFD (Still birth)

11. Intrapartum: Prolonged labor Unsuccessful TOLAC
Increased cesarean section – BMI dependent
Post vaginal delivery Hemorrhage
Increased OR times, intra-op bleeding
Anesthesia complications
Maternal death

12. Postpartum: Immediate Increased PPH VTE
Infection – wound complications and dehiscence
Delayed lactogenesis
Reduced duration of lactation
PPD and anxiety
Long Term
Weight management
DM follow up
HTN follow up
Baby with increased risk of child hood obesity

13. Material and Handling Considerations
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Material and Handling Considerations
Do the best that you can in the place where you are, and be kind.
Scott Nearing

14. Appropriate beds, chairs, wheelchairs, BP cuffs, lifts, scales, clothing, personnel.

15. OR considerations:
Tables, instruments, positioning, assistants,

16. We all just want a happy ending……..
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We all just want a happy ending……..
Babies are such a nice way to start people………
Don Herod