Pregnant Women with High BMI; Addressing its Antenatal Management

Abstract

Objective: The aim of the study was to evaluate the antenatal critical care of pregnant women with BMI =/> 40   in order to improve the adverse maternal outcome by improving antenatal care through implementation of standard national RCOG   guidelines. Materials and Methods: It was a retrospective study. Data retrieved from 52 patients with booking BMI of =/> 40 and entered on proforma on excel sheet. The audit department helped in analysis of data and results obtained. Results: In our study, 77% of women had BMI =/> 40 BMI and 23% had BMI =/> 45. Folic acid 5mg was prescribed to 43% of women and vitamin D to 60% at antenatal booking. Depending on additional risk factors, low dose Aspirin was started in 66% women and 60% women were advised to take low molecular dose heparin antepartum compared to 92% in postpartum. Antenatal anaesthetist clinic referral was done in 92% women and same number of women had their oral glucose tolerance test done. All women delivered in consultant led unit and only 14% women had postnatal infection. 64% women had vaginal birth compared to 36% delivered by caesarean section.  There was no still birth or early neonatal death however, 14% babies were admitted in neonatal care unit. Conclusion: Obesity is associated with poor maternal and fetal outcome. Consultant led antenatal care and following the national / local standard guidelines are needed to reduce the adverse outcome.