Pregnantly Obese

"More and more, I'm seeing younger and younger women falling into the class III obesity range." [Class III relates to a BMI of 40 or more; a BMI of 30 is where obesity is held to begin.]"The ones that concern me the most are younger women -- teens and women in their early 20s. But I also see class III obesity not uncommonly in my older moms, women over the age of 35."
Dr. Laura Gaudet, high-risk obstetrician, Moncton Hospital

The heavier the woman, the greater the risk for hypertension, gestational diabetes and emergency caesarean sections, during pregnancy. C-sections increase in parallel with increasing body mass indexes. One in two women with Class III obesity is delivered through C-section. Vastly overweight women are likelier to be induced "and when we induce labour, we inevitably see an increased risk in caesarian section", explained Dr. Gaudet.

A "high risk" patient with legal addictions to junk food and tobacco.

 

 

 

Babies born to obese mothers represent a twofold higher risk of congenital heart disease, spina bifida and additional birth defects. "Pretty much any birth defect is more common in obese women", observed Dr. Mark Walker, co-author of a new study, himself a high-risk obstetrician at The Ottawa Hospital. It becomes extremely difficult to detect such anomalies and abnormalities by ultrasound due to excess fat tissues around the abdomen.

Ultrasound probes are designed to work at a depth of five centimeters. "It's not uncommon to be working at a depth of 20 to 30 centimetres", said Dr. Gaudet, co-author of the study. Obese pregnant women become high-risk because of their weight; compared to women with normal BMI, overweight and obese women bear a significantly higher likelihood of pre-eclampsia, or gestational diabetes.

Pre-eclapsia is a rapid, potentially life-threatening rise in blood pressure and protein in urine which can lead to kidney or liver failure, brain swelling, seizures and death, if undetected in a timely manner. Babies risk fetal growth restriction and premature birth. Obesity among child-bearing age women in Canada stands at 23%; some women present to their obstetricians with a body mass index of 50, forcing hospitals to re-think their equipment.

"This wasn't an issue five years ago", commented Dr. Walker. Maternity wards now must purchase more robust operating room tables, extra-wide chairs, and heavier-duty scales, along with other specialized equipment, to manage the growing proportion of dangerously obese women in labour.