Obesity in pregnancy = BMI ≥30 kg/m² (≥35 kg/m² = severe obesity). It increases maternal and fetal risks, requiring multidisciplinary management including obstetric, anaesthetic, dietetic, and midwifery input 🩺.

🤰 Maternal Risks

🍬 Gestational Diabetes (GDM): Early OGTT recommended at booking + 24–28 weeks.
💉 Preeclampsia: Higher risk; consider low-dose aspirin if other risk factors.
🩸 VTE: Increased risk antenatally and postnatally; LMWH prophylaxis post-C-section.
🪷 Caesarean Delivery: Increased elective/emergency rates; anaesthetic risk (airway, regional blocks).
🚨 PPH: Higher risk → prophylactic oxytocics essential.
🦠 Infection: Wound, UTI, endometritis risk ↑.
😴 Sleep Apnoea: Screening advised for hypoxia risk.
🧠 Mental Health: Higher postnatal depression incidence.

👶 Fetal Risks

📏 Macrosomia / LGA: Shoulder dystocia, birth trauma; growth scans at 28 & 36 weeks recommended.
🧠 Congenital Anomalies: NTDs, cardiac defects ↑ risk.
⚰️ Stillbirth / IUFD: Consider enhanced surveillance after 37 weeks.
⏳ Preterm birth: Spontaneous or iatrogenic.
🍔 Childhood obesity: Long-term metabolic risk.

🩺 Antenatal Care

🧾 Preconception counselling: Weight optimisation, control comorbidities.
🍬 GDM screening: Early OGTT + standard 24–28 weeks.
🩸 BP monitoring: Regular checks, consider aspirin prophylaxis if indicated.
🖥️ Ultrasound: Growth scans at 28 & 36 weeks for macrosomia/polyhydramnios.
🥗 Nutritional guidance: Target gestational weight gain by BMI category.
🚶 Physical activity: 150 min/week moderate-intensity if not contraindicated.

🛑 Delivery Considerations

🪷 C-section planning: Consider if fetal macrosomia or other obstetric risk factors; anaesthetic risk planning.
⏱️ Labour management: Continuous fetal monitoring; shoulder dystocia preparation.
🩸 PPH prevention: Prophylactic oxytocics, vigilance.
🧦 VTE prophylaxis: LMWH ≥10 days postnatally; longer if additional risks.

🌸 Postpartum & Long-term

⚖️ Weight management: Structured support programs.
🍼 Breastfeeding: Encourage to support maternal weight and neonatal outcomes.
🦠 Infection monitoring: Close wound & urinary tract review.
🤰 Future pregnancies: Achieve healthy BMI preconception.
❤️ Chronic disease risk: Screen for T2DM, hypertension, and CVD postpartum.

📊 Obesity in Pregnancy – Summary Table (Emoji Version)

Category	Risks	Monitoring / Investigation	Management / Intervention	Postpartum / Long-Term Advice
🤰 Maternal	🍬 GDM, 💉 Preeclampsia, 🩸 VTE, 🪷 C-section complications, 🚨 PPH, 🦠 Infection, 😴 Sleep apnoea, 🧠 Mental health issues	🧾 Early OGTT, BP monitoring, urinalysis, sleep assessment, mental health screening	👩‍⚕️ Multidisciplinary care, prophylactic LMWH post-C-section, early aspirin if indicated, 🥗 diet & 🚶 exercise support	⚖️ Weight management, 💉 Diabetes screening 6–12 weeks, 🍼 Breastfeeding support, ❤️ Cardiovascular risk follow-up
👶 Fetal / Neonatal	📏 Macrosomia/LGA, 🧠 Congenital anomalies, ⚰️ Stillbirth/IUFD, ⏳ Preterm birth, 🍔 Childhood obesity/metabolic risk	🖥️ Growth scans 28 & 36 weeks, anomaly scan, fetal wellbeing monitoring if indicated	🪷 Delivery planning (C-section if >4500g), continuous fetal monitoring, shoulder dystocia preparedness	🍼 Encourage breastfeeding, 📏 Early growth monitoring, 🥗 Family healthy lifestyle support
🩺 Labour / Delivery	⏱️ Prolonged labour, ⚡ Shoulder dystocia, 🫁 Anaesthetic complications, 🩸 PPH	🖥️ Continuous fetal monitoring, 👩‍⚕️ Anaesthetic assessment	🔪 Plan C-section if indicated, 💊 Prophylactic uterotonics, 👶 Skilled birth attendance, 🩸 VTE prophylaxis	🩺 Monitor postpartum bleeding, 🦠 Wound care, 🩸 VTE risk, 🍼 Lactation support
🔮 Long-Term / Future Pregnancies	⚖️ Recurrence of obesity-related complications, ❤️ Chronic disease risk	🧾 Preconception review, BMI & metabolic monitoring	🥗 Weight optimisation, lifestyle programs, manage comorbidities	🤰 Pre-pregnancy counselling, ❤️ Ongoing cardiovascular/metabolic monitoring

📚 References

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Obesity and Pregnancy