Obesity

Maternal Obesity and Postpartum Hemorrhage

Obesity increases a person’s risk for developing a large number of disease, illnesses and conditions. It is a known fact that obesity during pregnancy increases the health risks for both the baby and the mom. Recent research now links maternal obesity to postpartum hemorrhaging.

It is worth mentioning that female obesity rates have increased more rapidly male obesity rates over the years. The Centers for Disease Control and Prevention have indicated that 35.5 percent of women over the age of 20 are considered to be obese.

What is postpartum Hemorrhage?

Postpartum hemorrhage refers to the blood loss following delivery. To qualify as a hemorrhage, blood loss should exceed 500 ml in case of vaginal delivery or 1000ml in case of a cesarean delivery. It is one of the most prevalent causes of maternal morbidity around the world.

Some of the common causes of hemorrhage are uterine atony, trauma inflicted during delivery, retained placenta tissue and coagulopathy (blood clots).

Research suggests that in obese women with a Body Mass Index (BMI) over 40, the risks of postpartum hemorrhage due to uterine atony will increase greatly. Atonic hemorrhage refers to the blood loss caused by continuous bleeding because of the inability of the uterus to contract.

Marie Blomberg, MD, Phd from Linkoping University, Sweden reported the findings in the September issue of the journal Obstetrics & Gynecology. Based on her research on Swedish women, she says that maternal obesity could put the risks of hemorrhage anywhere between 7% and 70%. She looked for a blood loss of more than 1000 ml to qualify it as hemorrhage.

The increase in the BMI of women was found to be directly proportional to the risks of atonic uterine hemorrhage. In the heaviest group of women, there was a two fold increase in the risks of postpartum hemorrhage. Compared to women of an average weight, obese ladies had a higher risk of bleeding post vaginal delivery.

They (obese women) had other clinical implications too. Maternal obesity increases the likelihood of the use of anticoagulants, such has heparin.

If you are thinking about becoming pregnant, it is important to consider weight loss should you fall into the category of obese.

References

Centers for Disease Control and Prevention: Pregnancy Complications

Children’s Hospital of Wisconsin: Postpartum Hemorrhage

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