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Maternal Obesity & Pregnancy Outcomes 321

e) Place preumatic compression stocking prior to Literature Review
during & until patient is fully ambulatory.
Pre-pregnancy maternal weight & Pregnancy out-
f) Additional DVT prophylaxis with LMWH should comes
be considered.
g) Begin early ambulation. h)Delay suture removal Study Outcome Type Of Study Result
to allow the skin to heal completely. Chu SY et al GDM Meta-analysis 3.6-fold &
(2007) 8.6-fold risk
Contraception & Future Pregnancy for obese &
severely obese
After present delivery the women should be advised Weiss JL et al Gestational Observational 2.5-fold risk
to continue the weight losing maintenance therapy (2004) HTN study for obese
as before ,as future conception will give better results women
when planned of the women had GDM,75 gm 2hr Weiss JL et al Pre eclampsia Observational 1.6-fold risk
OG TT should be performed at 6 wks Postpartum. (2004) study for obese
Birth spacing for 1-2 yrs is advisable ,Progestin bear- women
ing IUCD is the effective method of Contraception. HAPO STUDY Caesarean de- Observational ↑BMI, inde-
OG’s should be avoided due to the thrombotic side (2010) livery, neonatal study pendent of ma-
effects and failure rates directly proportional to in- adiposity ternai glycemia
creased BMI.After completion of family husband can results in PIH,
go for vasectomy. CS, ↑neona-
tal birth wt &
Management of obesity body fat
a) Life style modification –Diet & Exercise in con- Scothard KJ et C o nge nita l Meta-analysis Obese women
sultation with a Dietician & Physiotherapist. al (2009) anomalies are at ↑ odds
of congenital
b) Drugs –Orlistat -Selective inhibitor of gastric and anomalies
pancreatic lipase that inhibits absorption of lip- Reynolds RM ↑CV event in Observational 0.29 fold risk
ids in intertine. et al (2013) Adult offspring study of hospital ad-
mission for a
c) Sibutramine –Non adrenaline & 5HT reuptake CV event
inhibitor, acts as appetite inhibitor.

d) Metformin –Insulin sensitizer.
Conclusion
e) Bariatric Surgery – a) Excess Maternal Weight at any phase of preg-
1. Restrictive –Vertical banded gastroplasty, Lap- nancy has negative effects on pregnancy out-
aroscopic adjustable gastric banding. comes.
2. Male absorptive –Bilo pancreatic diversion. b) It predisposes women to various complications.
especially Gestational diabetes & Hypertension
3. Combination of Both. which eventually lead to more serious long term
4. Laparoscopic sleeve gastrostomy is now pop- problems like non communicable diseases.
ular particularly in younger women. c) A child born to an obese mother is more sus-
It is an irreversible reduction in the size of the stom- ceptible to obesity in adolescence& adulthood &
ach to 15 % of its original size..This reduces the hun- also Diabetes.
ger hormone ghrelin giving the person earlu satiety. d) Hence it is very important to reduce weight be-
This procedure helps to reduce 30-50% of weight in fore planning a pregnancy
6-12 mts.weight losing surgery should be done at-
least 1 year before planning pregnancy. e ) Weight reduction should be done be Diet ,Exer-
cise ,Drugs or Bariatric surgery according to the
individual need.

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