tag:blogger.com,1999:blog-4738062031052371885.post167045692046316224..comments2024-03-17T10:07:53.205-07:00Comments on The Well-Rounded Mama: Induction or Waiting in Obese First-Time Mothers?Well-Rounded Mamahttp://www.blogger.com/profile/04129621631406155340noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-4738062031052371885.post-26604083506180365032015-03-15T01:13:44.633-07:002015-03-15T01:13:44.633-07:00this is a very good article.i have these question ...this is a very good article.i have these question if u can answer them soon ill be glad<br /><br />can u explain the reason of electively inducing an obese women when already its a known fact that induction fails in them...can u mention any article which tells u the reason of "ELECTIVE" induction in obese women.<br />secondly expectant management in obese women is favoured can u tell any research article which favours this policy ..Anonymoushttps://www.blogger.com/profile/14831690022087793185noreply@blogger.comtag:blogger.com,1999:blog-4738062031052371885.post-49587358863541530972014-07-27T01:30:23.580-07:002014-07-27T01:30:23.580-07:00Good questions. Thanks for asking.
Yes, research ...Good questions. Thanks for asking.<br /><br />Yes, research clearly shows that larger babies are at higher risk for shoulder dystocia. Usually they measure "large" by the baby's weight; some define macrosomia as >4000g (just shy of 9 lbs.) but there's more research support for defining it as >4500g (9 lbs. 14 oz.). Smaller babies also experience shoulder dystocia but at a lower rate than larger babies.<br /><br />Baby's body build does have something to do with it. I'd be a lot more worried about a 10 lb baby who is 18 inches long than a 10 lber who is 23 inches long. Big babies of diabetic pregnancies in particular are more at risk, probably because they tend to have bigger shoulders and torsos.<br /><br />Yes, larger women on average have larger babies, which is why doctors are concerned and tend to induce. However, the risks of having a macrosomic baby are still relatively small, even in very high-BMI women, although the rate is increased over low-BMI women. Yet many providers forget that MOST high-BMI women do not have big babies and act as if their babies would all be huge.<br /><br />The assumption among many providers has been that since big women tend to make bigger babies, better induce while baby is smaller. But most research does not support doing this, and quite a bit actually indicates that inducing increases the risk for shoulder dystocia instead.<br /><br />Yet women of size are induced early on the assumption it will lessen the risk for shoulder dystocia all the time.Well-Rounded Mamahttps://www.blogger.com/profile/04129621631406155340noreply@blogger.comtag:blogger.com,1999:blog-4738062031052371885.post-42187160920838967282014-07-26T18:46:00.936-07:002014-07-26T18:46:00.936-07:00This is a very interesting look at an important su...This is a very interesting look at an important subject. Not being as well-versed in the literature, I would ask for clarification on two assumptions that seem to be built into inducing the labor of "obese" women in the hope of avoiding shoulder dystocia:<br /><br />1) Is a larger baby a greater risk for shoulder dystocia? Larger how? (E.g larger head circumference vs. fatter limbs.)<br /><br />2) Are larger women more likely to have larger babies?<br /><br />I can see how physicians might make these assumptions, but I wonder what the research finds. Thanks so much for your work, WRM.nsvnoreply@blogger.com