Quang Ninh29-year-old pregnant woman, weighing 98 kg, 35 weeks pregnant had premature labor, must have emergency surgery because of bleeding placenta syndrome.
The second-time pregnant mother, with obesity, BMI of 36.9, was taken to the emergency room at the On-Demand Department, Uong Bi Vietnam Sweden Hospital, last week. Doctors diagnose labor, bleeding placenta, horizontal position, pregnant women with gestational diabetes with a glycemic index twice higher than normal people, obese, and fetus weighing 2.4 kg.
Surgeons remove the baby, combine endocrine treatment. After surgery, mother and child are stable.
Dr. Vu Thi Dung, Deputy Head of the Department of On-Demand Treatment, said this is one of 28 cases of pregnant mothers who are overweight, obese and have delivered at the hospital since the beginning of the year. The heaviest case is a 31-year-old woman, weighing 152 kg, a BMI of up to 56.6. This woman was diagnosed with pre-eclampsia, a high risk of death during the surgery to capture her baby. At 40 weeks gestation, pregnant women are indicated by cesarean section, because they are too fat, so the doctor must carefully consider the dose of anesthetic drugs.
“The obese mother has a high risk of embolism during surgery, the baby is at risk of choking, trauma or respiratory failure after birth,” Dr. Dung said of the risk of the surgery. Fortunately, the surgery to catch the baby was favorable, the baby was born weighing 3.1 kg.
Dr Dung said the increasing rate of pregnant women who are overweight and obese is increasing. Being overweight is when the body mass index (BMI) is between 25-29.9, obesity BMI is 30 or above. In developing countries, obesity is quite common, concentrated in larger cities in the countryside.
The cause of obesity in pregnant women is by providing too many nutrients during pregnancy or before becoming overweight and obese.
Dr Dung said, obesity during pregnancy is one of the main causes of miscarriage, birth defects, premature birth, pre-eclampsia, gestational diabetes, the mother can stop breathing when sleep …
Obese women will have to undergo a complicated birth process, difficult to deliver, often due to the expansion of the uterus that does not meet the size of the fetus or the amount of fat is too large, making it difficult to locate the vertebra. numb.
If pregnant women cesarean section, the risk of wound infection, the risk of embolism is also twice as high as the normal weight.
Not only is it harmful to the mother, but maternal obesity also directly affects the health of the fetus. Babies born are susceptible to heart birth defects or neural tube defects due to their mothers often suffering from metabolic diseases during pregnancy. The risk of premature birth, stillbirth (the higher the BMI, the greater the risk). In addition, children are susceptible to injury during a cesarean section due to being too big.
Obese women need to lose weight before pregnancy, ensure BMI below 27, by diet, exercise. If choosing the method of bariatric surgery, it is necessary to avoid pregnancy for 1-2 years.
Pregnant women who are obese should regularly have their blood sugar, liver, kidney, blood pressure and fetal screening tested during the first trimester of pregnancy. During the second trimester, from 26 to 28 weeks gestation, a blood glucose test and a glucose tolerance test should be performed to reduce the risk of preeclampsia and gestational diabetes. In the last two months, pregnant women are at risk of hypertension in pregnancy, pre-eclampsia, difficult delivery, premature birth … should be closely monitored.
Pregnant women need a doctor’s advice on nutrition throughout pregnancy.