Obesity

Question 1

What is obesity?

Answer 1

• it is the excessive accumulation of fat within the fat cells as a result of discrepancy between energy intake and energy expenditure
• diagnosed using BMI, BMI over 30

Question 2

What are some of the pre-disposing factors for obesity?

Answer 2

• gender - more common in women than men
• postcode - there are more cases in the north of the country than the south
• lifestyle - reliance on cars, fast foods
• mental wellbeing
• social class
• ethnicity
• genetics

Question 3

What are some of the complications?

Answer 3

• type 2 diabetes
• cardiovascular disease
• osteoarthritis
• infertility

Question 4

How is it treated?

Answer 4

• increasing overall muscle mass
• producing a sense of well-being
• depressing the appetite
• increasing the overall metabolic rate

Question 5

What are some of the issues of being obese in pregnancy?

Answer 5

• early miscarriage
• GDM
• hypertension
• pre-eclampsia
• venous thrombo-embolism
• anaesthetic problems
• late stillbirth/neonatal death
• neural tube defects
• fetal macrosomia
• fetal trauma
• NNU admissions

Question 6

What is the role of the midwife antenatally?

Answer 6

• calculate each women’s BMI -> any BMI over 30 should be referred to consultant to discuss intrapartum risks and management strategies
• women with BMI over 35 should be booked at a consultant led unit
• advise about healthy eating
• moderate exercise encouraged
• ascertain mobility
• continuity or care to foster self-esteem and self-confidence

Question 7

What are the risks in labour for women who are obese?

Answer 7

• prolonged labour
• shoulder dystocia
• operative birth
• difficulty in undertaking instrumental and operative procedures
• difficulty siting an epidural or spinal

Question 8

What is the role of the midwife in labour?

Answer 8

• continuous midwifery care
• encourage changes in maternal position throughout labour
• avoid dehydration
• observe progress
• FSE if difficulty with abdominal auscultation
• encourage birth in consultant-led unit