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Arch Gynecol Obstet. 2016 May;293(5):987-92. doi: 10.1007/s00404-015-3921-9. Epub 2015 Oct 23.

Maternal super-obesity.

Author information

1
Department of Prenatal Medicine, University Hospital of Schleswig-Holstein, Ratzeburger Allee 160, 23538, Luebeck, Germany. dhartge@gmail.com.
2
Department of Prenatal Medicine, University Hospital of Schleswig-Holstein, Ratzeburger Allee 160, 23538, Luebeck, Germany.

Abstract

PURPOSE:

Pregnant women with a body-mass-index (BMI) above 50 are referred to as "super-obese". For these women adverse pregnancy outcome and a higher risk of fetal congenital defects are major issues. This report focuses on the ratio development of super-obesity in pregnant women, as well as on prenatal ultrasound and pregnancy outcome in the super-obese gravida.

METHODS:

We reviewed data of all women with a BMI above 30 who delivered at our unit in a 15-year period between January 2000 and December 2014. Data of obese but not super-obese mothers were evaluated in comparison.

RESULTS:

Final evaluation comprised 69/20,711 pregnancies of super-obese mothers. Forty out of 69 women suffered from a preexisting condition requiring medical treatment. Fetal ultrasound evaluation revealed severe congenital defects in four cases. There were no missed and no false positive diagnoses. Elective cesarean section (c-section) took place in 26/69 cases, 21/69 had a secondary c-section. Twenty-two out of 69 women delivered vaginally. Mean gestational age at delivery was 38(+6) gestational weeks. Pregnancy was complicated by macrosomia in 17/69 pregnancies. Severe neonatal hypoglycemia occurred in 6/69 cases. The number of deliveries by super-obese mothers showed no marked variation during the study period. In contrast the rate of deliveries by obese, but not super-obese, mothers showed an increase.

CONCLUSIONS:

Maternal super-obesity poses a high-risk situation for mother and child which generally demands a higher amount of perinatal care. The number of deliveries by super-obese mothers remained stable over the study period. Primary c-section was the most frequent mode of delivery. Of the parturients who opted for vaginal delivery nearly half of the deliveries had to be completed by secondary c-section. Over-all peripartal maternal complications did not exceed average.

KEYWORDS:

Fetal macrosomia; High-risk pregnancy; Maternal hyperalimentation; Mode of delivery; Prenatal ultrasound

PMID:
26498605
DOI:
10.1007/s00404-015-3921-9
[Indexed for MEDLINE]
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