A cohort study on obstetric outcome of obese primigravida with spontaneous onset of labour at term

• Main Authors: Ismail, Hamizah, Nusee, Zalina, Syed Mohd Ridzuan, Sharifah Nurul Inas, Abd. Aziz, Karimah Hanim
• Format: Conference or Workshop Item
• Language: English; English; English
• Published: 2021
• Subjects: RG Gynecology and obstetrics
• Online Access: http://irep.iium.edu.my/98345/2/3rd%20place%20-%202021%20MRS%20Inas.png; http://irep.iium.edu.my/98345/7/MRS%20slides.pdf; http://irep.iium.edu.my/98345/8/A%20cohort%20study%20on%20obstetric%20outcome.pdf; http://irep.iium.edu.my/98345/
• Institution: Universiti Islam Antarabangsa Malaysia

Introduction: Obesity is a complex disease that has reached pandemic level with higher prevalence among women. Obese pregnant women are at higher risk of gestational diabetes, hypertension, prolonged pregnancy, poor labour progress, caesarean delivery, primary postpartum hemorrhage, OASIS and fetal complications such as NICU admission, and macrosomia. This study aimed to determine the prevalence of successful vaginal delivery and outcome of pregnancy among obese primigravida who presented with spontaneous labour at term. Materials and method: This prospective cohort study which was conducted in a tertiary hospital involving 250 obese primigravida (BMI ≥27.5kg/m2) and 250 normal BMI primigravida. Data was collected from August 2020 till January 2021 and was analysed using SPSS version 23.0. Descriptive statistics, Independent T test, and Mann Whitney test were used to analyse the data. Results: Our study found that there were no significant differences in the prevalence of vaginal delivery and caesarean delivery between obese and normal weight primigravida. There were also no differences in the duration of total or first stage of labour in obese and normal weight women except for those presented at 4cm cervical dilatation. No difference in labour complications such as postpartum hemorrhage and OASIS, with high successful delivery without complications. Obese women presented at 6cm had shorter delivery interval compared to the normal BMI women [2.41(1.58) vs. 3.61(1.78), p=0.026] and higher caesarean for the abnormal labour progress indication [28(71.8) vs. 11(28.2), p=0.019] despite having higher comorbidities [149(72.3) vs. 57(27.7), p=<0.001]. There was no difference in the outcome of fetus for both groups. Conclusion: With careful selection, obese women who present with spontaneous labour at term are safe to be allowed vaginal delivery as they have similar risk of augmentation of labour, duration of active labour, caesarean delivery, postpartum haemorrhage and OASIS despite having comorbidities. Fetuses/neonates had similar risk of abnormal CTG, meconium liquor, shoulder dystocia and admission to NICU.