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2021-1-HU01-KA220-HED-000027613 - COHRICE

Erasmus++

TEACHERS GUIDE

Weight related comorbidities in pregnancies, the role of the obesity epidemic

(Advanced level)



Slide 2.: Talk about the aim of this presentation

Slide 3.: Demonstrate the gender related incidence of obesity worldwide. Highlight which are the most affected countries and try to provide explanation for this phenomenone. For example, in the United States there is a tradition of fast-food consuming, since in this modern lifestyle people do not have time to sit down and eat in a normal tempo. Rushed eating habits lead to higher food and eventually calory intake, which is one of the major reasons for weight gain, etc. 

Slide 4.: Explain how body wight of an individual can be classifies into subgroups, and the what the body mass index is. 

Slide 5.: Demonstrates the incidence of obesity in the world with exact numbers.

Slide 6.: Talk about the development of obesity, in which the metabolic syndrome has a major impact. Reveal the definition of metabolic syndrome. 

Slide 7.: Shows how the diagnosis of metabolic syndrome can be established.

Slide 8.: Talk about obesity related diseases and their main causes. Highlight that obesity can affect several organs throughout the body and can lead to the development of diseases.

Slide 9.: Focus on pregnancy, and since obesity has been on the rise, it is observed that it leads to problems with fertility and reproduction. Talk about the key aspects.

Slide 10.: Talk about how the maternal body weight and metabolism alters during pregnancy. The metabolism shifts towards anabolism, there are noted alteration in the fat, protein, and carbohydrate metabolism. Eventually the blood serum level increases, the developing fetus, the amniotic fluid, the blood pooling placenta and increased wight of the uterus will add 5-6 kg extra to the body weight. Increased body weight therefore is normal during pregnancy, and fasting, or going on a strict diet is not recommended, because it can lead to the development of maternal ketosis. The table demonstrates how much weight gain is considered to be normal for each pregnant woman, based on their prepregnant weight. 

Slide 11.: This slide shows how obesity causes problems for the mothers, and what kind of conditions she can develop. 

Slide 12-13.: Shows the correlation between preecclampsia and obesity. Since obesity is condition associated with chronic inflammation, toxaemic pregnancy develops more frequent in obese pregnant woman. The slide demonstrates additional risk factors of obese woman, and highlights the key aspect of the previously mentioned association between the conditions.

Slide 14.: Shows the ratio of unfavorable pregnancy outcomes and increased incidence of maternal and fetal diseases in obesity. 

Slide 15.: Discuss the challenges of the management of obese patients surgically and anesthesiologicly. 

Slide 16.: Elaborated how obesity and increased subcutaneous fat accumulation will lead into a diagnostic challenge, due to the fact that fat tissue is a poor conductor of the ultrasound waves. Therefore, all ultrasound-based devices (Cardiotocography, transabdominal ultrasound, non-stress test, oxytocin challenge test) will face difficulties.

Slide 17.: But not only the fetal surveillance is challenging but there is higher chance of negative peripartum outcomes, including injuries, bleedings, etc. Explain each in detail why. For instance, obese woman has proven to have bigger than normal fetuses (macrosomia is more common), and it is a risk factor for not only cephalon-pelvic disproportion, but also for shoulder dystocia.

Slide 18.: Focus on postpartum complications of obese patients. For example, obese women tend to develop wound healing abnormalities more common, especially in the cesarean wound. Therefore, suction drainage and abdominal compression belts have the benefit to decrease fluid accumulation among the wider than normal subcutaneous tissues, which a key aspect of infection development. 


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