Induction of labour and intrapartum care in obese women

• The importance of a multidisciplinary approach to antenatal, intrapartum and post-partum care of obese women in order to improve maternal and neonatal outcomes.
• An increased incidence of post-dates pregnancy in obese women contributing to the increased need for induction of labour.
• The risks associated with induction of labour and intrapartum care of the obese parturient.
• The logistical, health and safety issues associated with the care of the obese woman in pregnancy.

The rising incidence of obesity in pregnancy has a significant impact on the provision of health services around the world. Due to the pathophysiological processes associated with the condition, the obese pregnant woman is at increased risks of induction of labour, caesarean section, post-partum haemorrhage, infection, longer hospital stay, macrosomia and higher perinatal morbidity and mortality. Labour is more likely to be prolonged and dysfunctional, leading to the requirements for higher doses of oxytocin and increased risks of operative deliveries and morbidity. A multidisciplinary approach to the planning of antenatal, intrapartum and postnatal care is vital to ensure a safe outcome for the obese pregnant woman and her baby. The need for supervision and attendance by senior obstetric staff is increased, emphasising the need to identify the appropriate place of birth for this high-risk group of women, placing a significant strain on the resources of health-care providers.