EXCESSIVE WEIGHT GAIN DURING PREGNANCY: OBSTETRICAL ASPECTS


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Abstract

Objective. To determine the specific features of the course of labor and delivery in patents with excessive gestational weight gain (EGWG). Subjects and methods. The investigation enrolled 110 primigravidae with EGWG and 115 with recommended one, as well as their neonatal infants. The intrapartum and postpartum complications, the frequency of aids and operations in the intrapartum period, neonatal weight, and their assessment using the Apgar scale were analyzed. Results. Within-group comparison revealed that in patients with normal pregravid weight, its excessive weight increment increases the rate of uterine inertia (27.3 and 15.7%), clinical incompatibility (11.8 and 4.3%), the need for labor induction (26.4 and 15.7%), labor augmentation (34.5 and 19.1%), and cesarean section (23.6 and 11.3%) (p < 0.05). The rate of fetal macrosomia in the presence of EGWG ((10.9 and 3.5%) was significantly higher than that during the recommended one (p < 0.05). Conclusion. EGWG impairs the mechanisms responsible for triggering and maintaining delivery and assists in increasing the risk of intrapartum clinical incompatibility. There is more often a need for labor induction or emergency cesarean section, which allows patients with EGWG to be referred to as a group at high risk for complicated labor.

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About the authors

Vita Nikolaevna Pokusaeva

Smolensk State Medical Academy

Email: vita.pokusaeva@yandex.ru
MD, associate professor, the Department of obstetrics and gynecology with course of prenatal diagnostics Smolensk 214019, Krupskaya str. 28, Russia

Anna Sergeevna Vakhrushina

Smolensk State Medical Academy

Email: annaabrosimova@yandex.ru
post-graduate student, the Department of obstetrics and gynecology with course of prenatal diagnostics Smolensk 214019, Krupskaya str. 28, Russia

Elena Ivanovna Marinovicheva

Smolensk State Medical Academy

Email: roddom.bsmp@yandex.ru
PhD, assistant professor, the Department of obstetrics and gynecology with course of prenatal diagnostics Smolensk 214019, Krupskaya str. 28, Russia

Elena Alexandrovna Stepankova

Smolensk State Medical Academy

Email: agkpd@smolgma.ru
MD, professor, the Department of obstetrics and gynecology with course of prenatal diagnostics Smolensk 214019, Krupskaya str. 28, Russia

Ludmila Alexandrovna Shalkina

Smolensk State Medical Academy

Email: l.shalkina@yandex.ru
post-graduate student, the Department of pediatrics and neonatology Smolensk 214019, Krupskaya str. 28, Russia

Nikolay Konstantinovich Nikiforovsky

Smolensk State Medical Academy

Email: nk.nikiforovsky@yandex.ru
MD, professor, Head of the Department of obstetrics and gynecology with course of prenatal diagnostics Smolensk 214019, Krupskaya str. 28, Russia

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