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ACOG Publishes Guidelines for Physicians Caring for Obese Pregnant Women, USA

The American College of Obstetricians and Gynecologists on Wednesday released guidelines for physicians caring for obese pregnant women, which are expected to be published in the September issue of the journal... Obstetrics & Gynecology, Toronto's Globe and Mail reports (Picard, Globe and Mail, 9/1). The guidance -- which details possible health and childbirth-related complications for obese pregnant women and their infants -- represents the group's first committee opinion on obesity during pregnancy. About one-third of adult U.S. women are obese, according to an ACOG release (ACOG release, 8/31). Obese women and women who gain excessive weight during pregnancy face additional increased risks during pregnancy, including diabetes, hypertension, preeclampsia, blood clots and complications during labor and are more likely to have fetuses with neural tube defects, experience birth trauma and miscarry late in pregnancy (Kaiser Daily Reproductive Health Report, 8/22). "A lot of OB/GYNs don't bring up weight with patients," Laura Riley, immediate past chair of ACOG's Committee on Obstetric Practice, said, adding, "We're hoping to open the dialogue between patient and physician, so that patients come to understand that maintaining a healthy weight isn't just about how you look, but that it also has real medical implications" (ACOG release, 8/31). Recommendations
The guidelines recommend that women who are considering pregnancy try to reach a normal weight through diet and exercise before becoming pregnant. However, the guidelines warn against dieting during pregnancy, which can be dangerous (Globe and Mail, 9/1). The guidelines also include the following recommendations for OB/GYNs who are caring for obese patients:
Explain to patients the Institute of Medicine recommendations for weight gain during pregnancy (ACOG release, 8/31). IOM currently recommends that women with a normal pre-pregnancy weight gain 25 to 35 pounds during pregnancy, underweight women gain 28 to 40 pounds, overweight women gain 15 to 25 pounds and women who are obese prior to becoming pregnant gain 15 pounds during pregnancy (Kaiser Daily Reproductive Health Report, 8/22);

Record women's height and weight during the initial prenatal visit to conduct body mass index calculations;

Offer nutrition consultation to all obese women and urge them to follow an exercise program;

Consider screening obese pregnant women for gestational diabetes during the first trimester and repeating the testing later in pregnancy;

Inform patients of potential pregnancy complications related to obesity; and

Suggest patients consult an anesthesiologist prior to delivery because they are at high risk of requiring an emergency caesarean section (ACOG release, 8/31).

American College of Obstetricians and Gynecologists

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.





ACOG publicã Ghid pentru Medicii Îngrijirea obezi femeile gravide, SUA - ACOG Publishes Guidelines for Physicians Caring for Obese Pregnant Women, USA - articole medicale engleza - startsanatate