Backgroud

1. EXTREMELY OBESE (BMI > 40 Kg/m2) AND THEIR IMPACT ON PREGNANCY: A 6 MONTHS RETROSPECTIVE REVIEW IN HOSPITAL AMPANG, MALAYSIA. OPTIONALLOGO HERE OPTIONALLOGO HERE 1S KHALID, 1M MASRI, 1SHAMSIR ARIS, 2M GANESALINGAM 1Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia. 2Department of Obstetrics Gynaecology, Hospital Ampang, Malaysia. Backgroud Results Results Conclusions In terms of fetal outcome, seven (24.14%) NICU admissions were identified (one case due to prematurity at 34 weeks, two presumed sepsis (mother had leaking) , two cases of hypoglycaemia and two low apgar score due to HIE grade one and Pulmonary Hypertensive Disease of the Newborn. There was no statistically significant difference with the control group (p = 0.4932). It was noted that the average fetal weight among mothers of BMI > 40kg/m2 was 3.00kg compared to general population of 2.88kg. Again, no statistically significant difference was noted with p = 0.2176. Although the prevalence of morbidly obese women was small, we should be prepared to handle and manage pregnancy in morbidly obese patients. In a properly managed morbidly obese patient, a good outcome can be expected in term of maternal and fetal morbidity. However, care should be taken during labour as there are statistically significant increased in EMLSCS and PPH in this group. Maternal obesity is on a rise throughout most countries (1). During pregnancy, maternal obesity increases adverse maternal and fetal outcome such as gestational diabetes, hypertension and pre-eclampsia which then lead to preterm birth, reduced fetal growth and stillbirth (2-3). From 4896 cases, 29 (0.59%) patients with BMI of > 40kg/m2 were selected. The highest BMI recorded was 48.89kg/m2 with an average weight of 102.67kg, average height of 1.55m and a mean age of 29.6 years. All of the patients had MGTT done and nine (31.03%) were found to have Diabetes. Eight (28.66%) of patients had Hypertensive Disorders of Pregnancy. Four had Prelabour Rupture of Membrane (PROM), two had Oligohydromnios and one patient had DVT during pregnancy. Ten (34.48%) patients had LSCS with eight (80%) of them end up with EMLSCS (2 cases Eclampsia, 5 were foetal distress and one for failed IOL). When comparing mode of delivery between the morbidly obese patients with the control group, statistical analysis showed a significance difference with p = 0.0439. Five (17.24%) cases of PPH were reported with one readmission due to urinary tract infection. A highly significance difference (p = 0.0002) were noted. No wound breakdown was reported. Objectives To determine the prevalence of obese pregnant women with BMI of > 40kg/m2 in Hospital Ampang and its associated outcomes during pregnancy. Methods A six month retrospective study was conducted in Hospital Ampang from 1st March until 31st August 2011. All pregnant patients with BMI of >40kg/m2 were included in this study. The maternal and fetal outcomes were then identified. Similar data for patients with normal BMI (<25kg/m2) were collected for a control group. References • Heslehurst N, Rankin J, Wilkinson JR, Summerbell CD. A nationally representative study of maternal obesity in England, UK: trends in incidence and demographic inequalities in 619 323 births, 1989– 2007. Int J Obes 2009;34:420–8. • Yu CKH, Teoh TG, Robinson S. Obesity in pregnancy. BJOG 2006;113:1117–25. • Andreasen KR, Andersen ML, Schantz AL. Obesity and pregnancy. Acta Obstet Gynecol Scand 2004;83:1022–9.