Prenatal care tips in obese women

Publish Year: 1398
نوع سند: مقاله کنفرانسی
زبان: English
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DTOGIMED03_025

تاریخ نمایه سازی: 26 بهمن 1398

Abstract:

The patient should receive information regarding potential pregnancy risks associated withobesity, diet and gestational weight gain, and exercise. Her diet, change in weight, and physicalactivity should be reviewed frequently throughout pregnancy and the postpartum period.For the obese gravida, limiting gestational weight gain may reduce the risk of some adversepregnancy outcomes, such as macrosomia.However, weight loss has been associated with an increased risk of small for gestational agenewborns.Pregnant women can continue most prepregnancy exercise programs or initiate an exerciseprogram, which can help control gestational weight gain and may improve some pregnancyoutcomes (eg, reduced risk of gestational diabetes). Obese women are not at increased risk forfetal aneuploidy compared with women of normal BMI; however, obesity can affect screeningtest performance. Cell-free fetal DNA screening is more likely to result in test failure or aninaccurate result in obese women because they may have a lower fetal fraction of the cell- freeDNA. If underlying cardiopulmonary disease is suspected, cardiology or pulmonology referral isappropriate for evaluation and management. Obese women with additional risk factors fordevelopment of preeclampsia may benefit from treatment with low dose aspirin (eg, 81 mg). Adetailed (not basic) fetal anatomic survey is performed at 18 to 24 weeks of gestation to screenfor fetal anomalies.Due to the limitations of ultrasound with increasing degrees of obesity, we suggest concomitantuse of maternal serum alpha fetoprotein to screen for neural tube and other relevant congenitaldefects.