Challenges of Intrapartum Care in Obese Women

There is good evidence to show that maternal obesity contributes to poorer outcomes for both the woman and her baby during delivery. Known complications include increased risks for induction of labour, Caesarean section, post-partum haemorrhage, infection, longer duration of hospital stay, macrosomia and higher perinatal morbidity and mortality. Obese women are more likely to be admitted earlier in labour, require higher doses of oxytocin and have longer labours. The risk of Caesarean section, which is more difficult and associated with increased morbidity in obese women, is two to three times that of the general obstetric population. Due to the increased risks associated with obesity, and the intrapartum challenges that may arise, specific planning of delivery and optimal foetal monitoring are required for the obese parturient, as while a number of these woman may have uncomplicated deliveries, many will not. The need for supervision and attendance by senior obstetric staff is increased.