Obesity in pregnancy: Altered onset and progression of labour

Backgroundthe incidence of obesity increases in all developed countries to frightful percentages, also in women of reproductive age. Maternal obesity is associated with important obstetrical complications; and this group also exhibits a higher incidence of prolonged pregnancies and labours.Objectiveto review the literature on the pathophysiology of onset and progression of labour in obese woman and translate this knowledge into practical recommendations for clinical management.Methodsa literature review, in particular a critical summary of research, in order to determine associations, gaps or inconsistencies in this specific but limited body of research.Findingsthe combination of a higher incidence of post-term childbirths and increased inadequate contraction pattern during the first stage of labour suggests an influence of obesity on myometrial activity. A pathophysiologic pathway for altered onset and progression of labour in obese pregnant women is proposed.Conclusionsanalysis of the literature shows that obesity is associated with an increased duration of pregnancy and prolonged duration of first stage of labour.Implications for practicean adapted clinical approach is suggested in these patients.