OBSTETRICAL AND PERINATAL CONSEQUECES OF PREGNANCY IN OBESE WOMEN
DOI:
https://doi.org/10.11603/24116-4944.2017.1.7496Keywords:
obesity, pregnancy, complications.Abstract
The aim of the study – to evaluate the character and frequency of obstetrical and perinatal complications in obese pregnant women.
Materials and Methods. On the base of Kyiv Municipal Maternity Home number 6 we conducted a retrospective analysis of labor histories of obese women in 2015–2016. The course of pregnancy, delivery, postpartum period and condition of a fetus and a newborn was analyzed in 100 obese women (BMI > 30 kg/m2), who were devided in three groups depending on the obesity level: 1a – (48 women with I stage of obesity, 1b – 32 women with II stage of obesity and 1c – 20 women with III stage. Control group consisted of 100 women without obesity.
Results and Discussion. Pregnancy course analysis in obese women during first pregnancy trimester showed high level of abortion threatening 25 % against 10 % in control group. The most frequent complications in the second pregnancy trimester were: gestational hypertension, which occurred in 22 % of obese women, preeclampsia developed in women with BMI>30 in 4 times more frequently than in women with BMI<25. In pregnant with obesity placental dysfunction was observed twice more often than in women with normal body mass. In III trimester of pregnancy the percent of women with preeclampsia doubled with each 5–7 kg/m² BMI. Gestational hypertension occurred in 5 times more often in obese women. In women with BMI >30 placental dysfunction presented in 3 times more frequently comparing to women with normal body mass. Evaluated percent dependence of preterm and postponed deliveries from BMI, that happened in 2 times more often in women with obesity. Risk of inducted labor increased in three times in pregnant with BMI>30. Percent of caesarian section raised in high BMI and compiled 22 % in obese against 8 % in normal BMI. The most frequent indications for the caesarian section were: primary (5 %) and secondary (7 %) labor weakness, fetal distress (7 %), severe preeclampsia (7 %) comparing to the data of pregnant without obesity (2 %, 2 %, 3 %, 0 % respectively).
Conclusions. Provided investigation proved that obesity not depending from its severity is a premorbid state for complicated course of pregnancy and delivery, what leads to the development of unfavorable perinatal consequences. Further studying of metabolic features in obesity and evaluation of pathogenic mechanisms of pregnancy and delivery complications formation will provide the development of effective management tactics of obese women both in pregravidal and gestational periods what will lead to the decreasing of obstetrical and perinatal complications frequency.
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