Overweight mother, risks of pregnancy

[fedor]

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patient: 29yo white female, sedentary, unemployed, recently uninsured, obese (265lbs).

Presents with history of IBS and fibromyalgia.

Complains of dizzyness when standing. Referral to cardiologist for EKG and stress test, results negative. all bloodwork normal.

Patient states the desire to become pregnant as soon as possible and hopes to bear from 5 to 8 children in the next decade.

What would be the dangers of pregnancy to her and her baby in her current situation? What would you Ob/Gyns say as to the risks in this case? Preclampsia? Gestational diabetes? Other complications?

Personally I would recommend a sensible diet to lower patient's weight as well as an exercise program to strengthen heart, lungs, lower back, in preparation for pregnancy. Would it be irresponsible not to discourage patient from attempting to get pregnant at this time?

 

[Poety]

patient: 29yo white female, sedentary, unemployed, recently uninsured, obese (265lbs).

Presents with history of IBS and fibromyalgia.

Complains of dizzyness when standing. Referral to cardiologist for EKG and stress test, results negative. all bloodwork normal.

Patient states the desire to become pregnant as soon as possible and hopes to bear from 5 to 8 children in the next decade.

What would be the dangers of pregnancy to her and her baby in her current situation? What would you Ob/Gyns say as to the risks in this case? Preclampsia? Gestational diabetes? Other complications?

Personally I would recommend a sensible diet to lower patient's weight as well as an exercise program to strengthen heart, lungs, lower back, in preparation for pregnancy. Would it be irresponsible not to discourage patient from attempting to get pregnant at this time?

Personally I wouldn't advise her not to get pregnant - reasons being that where I go to med school we have even have had a 42 y.o. women with the deisre to become pregnant after having muliple losses and because of cultural reasons, we could do testing, but not "advise" not to get pregnant unless there was a real medical reason (i.e. kidney failure, liver failure, known dominant genetic abnormality, etc) But maybe you could say that her body would have a better chance at retaining the pregnancy and being prepared for so many others if she lost some weight and started an excercise program -

big risks are as you stated, and risk for delivery - CPD/arrest of decent/PTL . Those are all I can think of right now!

🙂