ABSTRACT
With obese women (BMI >40):
The possibility of missing abnormalities on scans is higher.
Monitoring the baby in labour is more difficult.
Siting epidurals is difficult.
Surgery is more difficult.
There is a risk of thromboembolism.
Breastfeeding is important to help postnatal weight loss.
Preventative management of pressure sores is important.
A larger operating theatre table is required.
Alert SpR and anaesthetist.
Check for any care plan devised antenatally.
Use an appropriate size sphygmomanometer cuff to measure BP.
Secure venous access as early as possible.
Consider insertion of arterial line, especially if pre-eclamptic.
Group-and-save (increased risk of PPH).
VTE prophylaxis per protocol.
Anticipate shoulder dystocia.
Senior obstetrician to be present if CS is required and BMI is >40.
