Obesity is becoming a global health care problem and an increasing number of obese female patients are getting pregnant. Aim of our study was to know the prevalence of obesity in nulliparous women and its impact on pr...Obesity is becoming a global health care problem and an increasing number of obese female patients are getting pregnant. Aim of our study was to know the prevalence of obesity in nulliparous women and its impact on pregnancy as well as fetus. Patients and Methods: All nulliparous women with single pregnancy and gestational age of 37 weeks and above were included in the study. Primigradvida with multiple pregnancies, fetal abnormalities, and gestational age less than 37 weeks were excluded. Patients were divided into normal, overweight and obese group according to their prepragnancy body mass index (BMI). Results: Total 2243 nulliparous women were included in the study, majority (56.8%) of patients were in the normal BMI group and only 24.8% were obese. But a significantly higher number of obese nulliparous women were in the age group of 18 to 29 years (P < 0.05). Comorbidities were significantly higher in obese primigravida. The incidence of gestational diabetes and pregnancy induced hypertension was significantly higher (P 0.05) in obese nulliparous women. Overweight and obese nulliparous patients required significantly higher emergency caesarean section and assisted vaginal deliveries compared to the normal BMI nulliparous women (P < 0.03). Conclusion: Maternal obesity leads to prepartum, peripartum as well as fetal complication. Obese pregnant patients had a significant risk of developing gestational diabetes and pregnancy induced hypertension. In these patients the prevalence of assisted vaginal and cesarean deliveries is significantly high.展开更多
Pregnancy and peripartum period leads to Virchow’s triad (hypercoagulability, venous stasis and vascular injury) thereby increasing the risk of thromboembolism by many folds in these patients. Accurate diagnosis of p...Pregnancy and peripartum period leads to Virchow’s triad (hypercoagulability, venous stasis and vascular injury) thereby increasing the risk of thromboembolism by many folds in these patients. Accurate diagnosis of peripartum pulmonary embolism is pertinent for reducing morbidity and mortality. Accurate diagnosis is also vital for avoiding the adverse effects of unwanted anticoagulation in pregnant mother and fetus in a patient wrongly diagnosed with this condition. Computerized tomographic pulmonary angiography has a high specificity and sensitivity in comparison to ventilation/perfusion scan for diagnosis of peripartum pulmonary embolism (PPE). It has a lower fetal radiation exposure and aids in arriving at an alternative diagnosis, if PPE is absent. Low molecular weight heparin is the medication of choice in the treatment of peripartum pulmonary embolism. Thrombolysis is considered in patients with massive PPE and hemodynamic instability, refractory hypoxia or right ventricular dysfunction. Regional anesthesia/analgesia can be given safely in these patients. We report two cases of PPE and review the anesthetic and surgical consideration.展开更多
文摘Obesity is becoming a global health care problem and an increasing number of obese female patients are getting pregnant. Aim of our study was to know the prevalence of obesity in nulliparous women and its impact on pregnancy as well as fetus. Patients and Methods: All nulliparous women with single pregnancy and gestational age of 37 weeks and above were included in the study. Primigradvida with multiple pregnancies, fetal abnormalities, and gestational age less than 37 weeks were excluded. Patients were divided into normal, overweight and obese group according to their prepragnancy body mass index (BMI). Results: Total 2243 nulliparous women were included in the study, majority (56.8%) of patients were in the normal BMI group and only 24.8% were obese. But a significantly higher number of obese nulliparous women were in the age group of 18 to 29 years (P < 0.05). Comorbidities were significantly higher in obese primigravida. The incidence of gestational diabetes and pregnancy induced hypertension was significantly higher (P 0.05) in obese nulliparous women. Overweight and obese nulliparous patients required significantly higher emergency caesarean section and assisted vaginal deliveries compared to the normal BMI nulliparous women (P < 0.03). Conclusion: Maternal obesity leads to prepartum, peripartum as well as fetal complication. Obese pregnant patients had a significant risk of developing gestational diabetes and pregnancy induced hypertension. In these patients the prevalence of assisted vaginal and cesarean deliveries is significantly high.
文摘Pregnancy and peripartum period leads to Virchow’s triad (hypercoagulability, venous stasis and vascular injury) thereby increasing the risk of thromboembolism by many folds in these patients. Accurate diagnosis of peripartum pulmonary embolism is pertinent for reducing morbidity and mortality. Accurate diagnosis is also vital for avoiding the adverse effects of unwanted anticoagulation in pregnant mother and fetus in a patient wrongly diagnosed with this condition. Computerized tomographic pulmonary angiography has a high specificity and sensitivity in comparison to ventilation/perfusion scan for diagnosis of peripartum pulmonary embolism (PPE). It has a lower fetal radiation exposure and aids in arriving at an alternative diagnosis, if PPE is absent. Low molecular weight heparin is the medication of choice in the treatment of peripartum pulmonary embolism. Thrombolysis is considered in patients with massive PPE and hemodynamic instability, refractory hypoxia or right ventricular dysfunction. Regional anesthesia/analgesia can be given safely in these patients. We report two cases of PPE and review the anesthetic and surgical consideration.
