Ultrasound in the management of obesity in pregnancy

Obesity during pregnancy can cause various health problems for a baby that include-

1-Macrosomia- Women who are obese are at the increasing risk of delivering an infant baby who is significantly larger than the average baby and has more body fat than the usual. It has been suggested in the research that as the birth weight increases, so does the risk of childhood obesity.

2-Chronic conditions- Being obese during pregnancy might increase the risk that your baby will develop heart disease or diabetes when he/she grows as an adult.

3-Birth defects- According to the research and report of Max Mongelli, obesity during pregnancy slightly increases the risk of having a baby who’s born with a congenital disability.

The pre-pregnancy weight of women and BMI, as well as the health, and child’s health, all of them play a role in determining how much weight you need to gain during the pregnancy. Ask your health care provider to determine what’s best in your case and also to manage the weight throughout the pregnancy.

Some general guidelines that you should know for pregnancy weight gain and obesity:

1-Single pregnancy- If you are obese and carrying one baby, recommended weight gain is 11 to 20 pounds that are about 5 to 9 kilograms.

2-Multiple pregnancy- If you are overweight and carrying twins or multiples, recommended weight gain is 25 to 42 pounds that are about 11 to 19 kg.

Some research suggests that women who are obese can safely gain less weight than the guidelines recommended. Rather than gaining or weight losing, your health care provider will ask you to focus on avoiding weight gain during the pregnancy.

If you are obese, then your healthcare provider will closely monitor your pregnancy. Depending on that, health care provider might recommend:

1-Early testing for gestational diabetes- A screening test called the glucose challenge test is often done between 24 and 28 weeks of pregnancy.

2-Fetal echo cardiography- This is a test that provides a detailed picture of your baby’s heart between 22 and 24 weeks of gestation. The test is used to rule out or confirm a congenital heart defect.

3-Delayed fetal ultrasound- It is typically done between 18 and 20 weeks of pregnancy to evaluate a baby’s growth and development.

Obesity can increase the risk of complications. To ease the anxiety, work closely with your healthcare provider.

Dr. Max Mongelli Research - All about prolonged pregnancy

Prolonged pregnancy is defined as pregnancy which progresses beyond 42 weeks. It is associated with fatal, neonatal, and maternal complications. Risks increase after term and significantly so after 41 weeks of pregnancy. According to Dr. Max Mongelli, induction of labour appears to improve outcomes and reduce perinatal mortality. Where possible, first trimester ultrasound rather than last menstrual period dating should be relied on to assess pregnancy duration. This should be determined using crown-rump measurement or head circumference if crown rump length is above 84mm.

Tests are used to monitor the health of a post term feteus and to determine whether it is safe to allow the pregnancy to continue or not.

Risks associated with post-term pregnancy

1) Fetal and neonatal risks

Post term pregnancy is associated with an increase in perinatal and mortality. There is an increased risk of still birth and neonatal death, as well as increase in risk of death in 1st year of life. The increased mortality is thought to be due to factors such as ultero- placental insufficiency, meconium aspiration and intrauterine infection.

Foetal morbidity also has higher risks of neonatal acidaemia and low five minute apgar scores, as well as the meconium aspiration. It can results in birth injury, and neonatal seizures.

Maternal risks

• There are increased risks for the mother, including:
• Obstructed labour
• Perineal damage
• Caesarean damage
• Instrumental vaginal delivery
• Postpartum haemorrhage
• Infection

Where labour is induced before the uterus or cervix are in a favourable state, obstetric problems may follow which can have an adverse effect on mother or baby, including:

• Need for c-section delivery
• Prolonged labour
• Traumatic delivery
• Postpartum haemorrhage

Risk factors

• Previous post term pregnancy increases the risk of recurrence of subsequent pregnancies.
• Primigravidity
• High maternal BMI is associated with longer gestation and increased rate of induction of labour. Elevated pre- pregnancy weight and maternal weight gain both increase the risk of a post term delivery.
• There is an increased risk for mothers who were themselves  born post term, and twin studies also suggest a genetic role
• Advanced maternal age

Interest & Recognization of Dr. Max Mongelli

Senior Staff Specialist and Clinical Associate Professor of Obstetrics and Gynecology, Dr. Max Mongelli works at the Western Clinical School, Nepean Hospital, University of Sydney, NSW. A distinguished member of his field, Max Mongelli is one of the most popular and reliable specialist at the Western Clinical School, Nepean Hospital and the work he has done in the past, and the recognition that he has got for it, has put him in a league of his own.

To further elaborate on this, some of his distinguished achievements are:

• Received the best established researcher award by Nepean Medical Foundation
• Written more than 85 articles in the fields of obstetrics and gynecology
• Received the United Kingdom Design Council Millennium Award
• Achieved high distinction in physics

This man believes that success can never be achieved by taking shortcuts and that’s the reason he has worked so hard to reach the position he is at today. Along with a long list of academic and professional qualifications, Dr. Max Mongelli has gained several distinctions and prizes for his research and studies as well. Being an active player of his field, he has also received recognitions from various departments of medicine and science. In 2002, he was appointed the Chairman of the Organizing Committee for Biennial Scientific Meeting of the Perinatal Society of Singapore. Apart from that, he was also the member of the organizing committee’s 5th & 6th Refresher Course of the Obstetric & Gynecological Society.

The achievements and recognitions of Max Mongelli are enough to justify the kind of work he does. His dedication and willpower to achieve heights in his field are what has brought him at this point of life where he is the best at what he does. Even at the hospital and the universities that he has taught at, his colleagues and students have only appreciated his work. He has had a long journey of success and it has all come to him thanks to his knowledge and hard work. His mates from the university, his friends, his family and even his acquaintances say that the way he consumes and spreads knowledge is extra-ordinary and something that is very rare in today’s medical community.