TITLE:
Audit of Obstetric Outcome in Morbidly Obese Women at Great Western Hospital NHS Foundation Trust UK
AUTHORS:
Emmanuel Ekanem, Lalrinawmi Lalrinawmi
KEYWORDS:
Pregnancy, Obesity, Body Mass Index (BMI)
JOURNAL NAME:
Open Access Library Journal,
Vol.7 No.5,
April
29,
2020
ABSTRACT: Obesity in pregnancy is a substantial public health problem with potentially dire consequences on pregnancy outcome for the mother and the neonate. Objective: To determine the prevalence and care of morbidly obese women (BMI > 40 kg/m2) in our obstetric population over one year against standards and criteria set by the Royal College of Obstetricians and Gynaecologists (RCOG) in the Green-top Guideline No. 72 “Care of women with Obesity in pregnancy”. Methods: This was a retrospective longitudinal cohort study conducted at the obstetrics department of Great Western Hospital NHS Foundation Trust UK. Data were collected from patients’ records on Medway Maternity software and hospital notes of women with BMI > 40 kg/m2 who delivered between 1st December 2017 and 31st December 2018. Data were analyzed using Epi info version 7.0. Results were presented in tables and charts. Results: During the period of the audit, there were a total of 4198 deliveries. The number of morbidly obese women was 145, giving a prevalence of 3.45%. Majority of the women (42) had no prepregnancy complications. Complications before pregnancy were previous miscarriages, polycystic ovarian syndrome, disc pro-lapse, diabetes, previous IUGR and hyperprolactinaemia. Antenatally, most patients had no complications. Gestational hypertension was the most common complication (9), followed by gestational diabetes (7), intrauterine growth restriction (1), placenta praevia (1), and severe preeclampsia (1). None of the patients had intrapartum complications in this study. Majority of the patients (46) had no postpartum complications, 11 had postpartum haemorrhage, 2 had postpartum hypertension, and one had wound infection and dehiscence. Compliance with care was 92.67%. Conclusion: This audit revealed that morbidly obese women in our obstetric population were at risk of some of the complications of obesity in pregnancy, labour, delivery and postpartum. The care for these women was within recommended standards with room for improvement.