George Guirguis
Rutgers New Jersey Medical School, USA
Title: Delivery risks and management guidelines for the obese pregnant patient
Biography
Biography: George Guirguis
Abstract
Thirty four percent of women in the United States (US) age 20-39 meet criteria for obesity (BMI >30) and this number continues to increase. Obese patients with BMI above 60 are increasing 5 times faster than any other obesity category. It is imperative that providers caring for the reproductive age obese women understand and communicate pregnancy related risks in this cohort of patients. Compared to normal weight women, obese pregnant women have increased pregnancy and delivery related risks, which can result in compromise to mother, fetus, or both. Delivery related challenges include difficulty with fetal monitoring, increase rate of cesarean delivery and additional intra-operative risks. Delivery may be complicated by fetal injury and maternal post-operative course may be further compromised. Mode of delivery should be discussed during prenatal care; however cesarean delivery may be the safest route of delivery for the obese patient with a BMI above 60. Delivery of the obese gravida requires surgical expertise and interdisciplinary planning with teams familiar with obesity management, to reduce maternal and fetal morbidity. We review delivery related risks and provide recommendations for delivery and postpartum management of the obese pregnant patient. We additionally provide recommendations for intrapartum and postpartum coordination of care with bariatric specialists.