Nazia Liaqat, Saadia Yasmeen, Tanveer Shahid, Rehana Rahim


Background: The increasing rate of maternal obesity provides a major challenge to obstetric practice. Maternal obesity can result in negative outcomes for both women and fetuses. The objective of this study was to determine the frequency of various types of operative and assisted deliveries in pregnant obese women at term.
Material & Methods: This cross-sectional study was conducted at Department of Gyne/Obs, Lady Reading Hospital, Peshawar from 25th August 2010 to 25th November 2010. Pregnant women whether primigravida or multigravida with alive singleton pregnancy at term with BMI >30 calculated at 8 to 12 weeks of gestation were included in the study. Patients who with diabetes, hypertension and other major medical illnesses were excluded. Patients with absolute indications for cesarean section like contracted pelvis and major type placenta previa were also excluded. These patients were divided into two groups; Group A with BMI 30-35 kg/m2 and Group B with BMI 36-40 kg/m2. Pevic examination was done to confirm labour and presentation. Routine investigations like complete blood picture, blood group, random blood sugar and virology was sent. All labours were plotted on the partogram and patients were followed till delivery. Labour progress was followed till delivery and if progress delayed then instrumental delivery /caesarean section was decided. Patients’ data was recorded on a pre-designed proforma.
Results: The mean age of 126 patients included in the study was 28±3.92 years. The mean gestational age was 38±2.47 weeks. Most of the patients 96 (76%) were in 37-40 weeks, followed by 30 (24%) in 41-42 weeks. Status of gravida was analyzed as 48 (38%) primigravida and 78 (62%) multigravida. Among multigravida, 41 (32%) patients were in G2 to G4, 26 (21%) in G5 to G7 and 11 (9%) in G8 or more. The mean BMI was 33±1.82 kg/m2. Out of these patients 98 (78%) were in Group A and 28 (22%) were in Group B. Among these 126 patients, 38 (30%) had C-section while 19 (15%) had instrumental deliveries in which 13 (10%) patients had vacuum delivery and 6 (5%) patients had forceps delivery. Comparing the two groups, there were 30 (30.60%) patients in Group A undergoing C-section as compared to 8 (28.57%) patients in Group B. Assisted delivery was also higher in group A 11 (11.22%) as compared to group B 2 (7.14%). The difference between the C-section and assisted delivery among the two groups was statistically not significant (p>0.05).
Conclusion: It is concluded that there is high rate of cesarean section and instrumental delivery in obese women. However, there is no significant difference among the moderately obese and severely obese ones.

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