OBESITY -ANS module part2

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1) 17) You see a couple in the Gynaecology clinic with subfertility of 18

months' duration. The woman, who is generally healthy, has a BMI of 24

kg/m2 and is ovulating normally as evidenced by 21-day progesterone

test. The man, who is a smoker, has a BMI of 44 kg/m2

.What is the likely

impact of his high BMI on their fertility?

2) A 32-year-old primigravida woman books at 12 weeks gestation with a BMI of 55. What

management would you advocate?

3) A 28-year-old woman with a BMI of 40 at booking and weighing 120 kg, had a Neville Barnes forceps birth with an episiotomy and is requesting an early discharge. She had an uncomplicated pregnancy and does not like staying in hospital.

How would you advise this woman?

4) 36/40 weeks pregnant woman in her second pregnancy, and with a BMI of 41 at booking, presents in the antenatal clinic to discuss the mode of birth. Her scan today shows a normal size baby. She had an emergency Caesarean section 3 years ago with her first baby at full dilatation with no subsequent complications.

What would be the most appropriate advice at this point in her management?

5) A 22-year-old primigravida attends for post-dates induction of labour at 41+5 weeks of gestation. At booking her BMI was 32 (weight 95 kg). There is no significant past medical history and she has been well antenatally.

Following induction with prostaglandins and syntocinon she had a normal vaginal birth, although the placenta was not delivered for 50 minutes. The blood loss was estimated to be 1300 ml.

What is the most appropriate postnatal thromboprophylaxis method for this woman?

6) MMD25

Regarding pregnancy outcome after bariatric surgery in obese reproductive age

women, which of the following is true?

7) Retake quiz

A 29-year-old para 1 with a booking BMI of 42 (121 kg) attends at 39+1 weeks of gestation with a history of regular contractions and spontaneous rupture of the membranes.

Her first baby was born three years ago by emergency caesarean section for suspected fetal compromise when the cervix was 7 cm dilated.

In this pregnancy, the antenatal course has been uncomplicated and she is aiming for a vaginal birth. On examination, the cervix is 5 cm dilated and the liquor is clear.

What would be the most appropriate management?

8) 54) What is the main difference between an obese and a non-obese

woman undergoing IVF/ICSI with respect to live birth rates after their

first ART cycle?

9) 55) What would be the recommended duration of physical activity for a

30 year old obese (body mass index of 33 kg/M2) woman who is trying

to conceive?

10) 111. Which obstetric complication has a significantly increased likelihood in women

who have undergone bariatric surgery?

11) A 20-year-old para 1 is seen for booking at 12 weeks gestation. In her first pregnancy she had a spontaneous vaginal birth at 38 weeks. She has a BMI of 33 (weight 85 kg) and smokes 10 cigarettes per day. She is otherwise fit and well and is not on any medication other than folic acid 5 mg which was prescribed by her GP.

What would be the most appropriate management for her pregnancy?

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