Obesity. The method of choosing delivery in pregnant women with a large fetus Alimentary constitutional obesity of the 1st degree
The owners of the patent RU 2496416:
The invention relates to medicine, namely to obstetrics. To choose the method of delivery in pregnant women with a large fetus, the degree of alimentary-constitutional obesity (ACO), parity of childbirth, the presence of diabetes mellitus are assessed, the abdominal circumference, the height of the woman are measured, the age of the woman is determined, the duration of pregnancy and the sex of the child are determined, each clinical sign is evaluated in points. In the absence of ACH, 0 points are assigned, in the presence of grade I ACH, 1 point is assigned, grade II - 2 points, grade III - 3 points. The first births are estimated at 3 points, repeated births - 0 points. The presence of diabetes mellitus is estimated at 3 points, the absence of diabetes mellitus - 0 points. Abdominal circumference 98-100 cm is scored as 0 points, 101-103 cm - 1 point, 104-106 cm - 2 points, more than 107 cm is scored as 3 points. A woman's height above 166 cm is estimated at 0 points, 163-166 cm - 1 point, 159-162 cm - 2 points, below 159 cm - 3 points. The age of a woman 18-23 years old is estimated at 0 points, 24-29 years old - 1 point, 30-35 years old - 2 points, over 35 years old - 3 points. The gestational age of 38 weeks is estimated at 0 points, 39 weeks - 1 point, 40 weeks - 2 points, 41 weeks - 3 points. The male gender of the fetus is estimated at 2 points, the female gender of the fetus is 0 points. The scores obtained are summarized, and if the total score is less than 9, childbirth is carried out through the natural birth canal, and if the total score is 9 or more, delivery is performed by caesarean section. The method improves the accuracy of the choice of delivery in pregnant women with a large fetus by analyzing the most significant clinical signs. 2 tab., 3 pr.
The invention relates to the field of medicine, namely to obstetrics, and can be used when choosing the tactics of conducting labor in pregnant women with a large fetus.
According to WHO data, the growth of birth injuries, perinatal morbidity and mortality among children born weighing more than 4 kg is increasing every year. One of the most important reasons that determine the level of reproductive losses, as well as the frequency and severity of complications, as well as diseases of the fetus and mother, traumatic genesis, during childbirth, is the disproportion between the size of its head and the mother's pelvis. The frequency of a clinically narrow pelvis is 1.3% -1.7% of the total number of births. At the present stage of development of obstetrics, such obstetric situations are considered absolute indicators for caesarean section, in which surgical delivery must be performed not only in order to save the life of the mother and fetus, but also to prevent their disability. Relative indicators are those in which caesarean section, compared with delivery through the natural birth canal, improves the outcome of pregnancy and childbirth for the mother and fetus. If the presence of absolute indications does not raise any doubts about the need for surgical delivery, then relative indications, especially the occurrence of a clinical narrow pelvis and anomalies of labor in pregnant women with a large fetus, require the development of clear criteria for choosing the optimal delivery tactics.
Currently, a method is known for determining indications for a caesarean section in pregnant women with a transversely narrowed pelvis, which is based on an x-ray determination of the area of \u200b\u200bthe entrance to the small pelvis, its ratio to weight index, the fetus, the direct diameter of the wide part of the cavity and the interosseous diameter. The method has the following disadvantages: the complexity of the method, the presence of radiation exposure due to the need for X-ray examination, the lack of accuracy of the method due to the fact that the possibility of anomalies in labor is not taken into account, concomitant obstetric and somatic pathology.
There is a known method for choosing delivery tactics, which consists in the fact that on the eve of childbirth, nitric oxide metabolites are determined in the amniotic fluid of women at risk: nitrites and nitrates, and with their content of 0.62 μg / ml and above, delivery is carried out by caesarean section, and with the content below 0.62 μg / ml, childbirth is carried out through the natural birth canal. The method has the following disadvantages: insufficient accuracy due to the fact that the method is limited to only one clinical and laboratory indicator of nitric oxide metabolites, not taking into account the influence of other mediators on the development of labor anomalies, concomitant obstetric and somatic pathology.
There is a known method for choosing delivery, taken as a prototype, which consists in the fact that to select the tactics of delivery on the eve of childbirth, clinical and laboratory criteria are evaluated on a two-point scale: the age of the mother, indicators of cardiotocographic monitoring, complications of this pregnancy (OPG-gestosis, threatened miscarriage, extragenital pathology, fetal malnutrition and the first degree of placental maturity according to ultrasound), platelet aggregation and cortisol levels in the mother's blood, which determine the subsequent choice of the method of delivery. The scores are summarized and, with a score of more than 12, a planned operative delivery by caesarean section is recommended.
However, the method has the following disadvantages:
1. The complexity of the method due to the need for several biophysical and biochemical research methods that require special equipment and time.
2. Insufficient accuracy of the method due to the fact that the prognostic data of cardiotocography do not always find subsequent confirmation, the level of cortisol in the blood of women does not always reflect the compensatory capabilities of the fetus, an increase in platelet aggregation is observed in various pathological conditions that are not associated with the need for surgical delivery.
To simplify and improve the accuracy of the method of delivery in pregnant women with a large fetus, on the eve of childbirth, the degree of alimentary-constitutional obesity (ACO), parity of childbirth, the presence of diabetes mellitus (DM) are assessed, the abdominal circumference and height of the woman are measured, the woman's age is determined, the duration of pregnancy and the sex of the child are determined. , each of the listed signs is evaluated in points from 0 to 3, according to table 1, the points are summed up and, with a score of less than 9, childbirth is carried out through the natural birth canal, and with a sum of 9 or more points, delivery is performed by caesarean section.
The selection of criteria for scoring was carried out on the basis of an analysis of the significance of clinical signs for the course of childbirth according to the construction of a mathematical model, based on the methods of regression analysis. Of all the analyzed factors, the most significant ones were identified and a criteria assessment scale was developed (Table 1).
The method is carried out as follows: upon admission of a pregnant woman for antenatal hospitalization in a hospital, an anamnesis is taken with specification of the woman's age, parity of childbirth, the degree of ACH and the presence of diabetes mellitus, the height of the woman and the circumference of the woman's abdomen in cm are measured using a centimeter tape, the sex of the fetus is determined according to the data III screening ultrasound and gestational age on the eve of childbirth on the first day of the last menstruation and the data of I screening ultrasound. Each of the listed signs is evaluated in points from 0 to 3, the points are summed up, and with a score of less than 9, childbirth is carried out through the natural birth canal, and with a sum of 9 or more points, delivery is performed by caesarean section.
Example 1. Pregnant P., aged 24, was admitted on 12/11/11 to the Department of Pregnancy Pathology with a diagnosis of Chronic placental insufficiency, compensated form at 39 weeks' gestation. Large fruit. Neurocirculatory dystonia (NCD), hypotonic type. H 0 .
From the anamnesis, it was found out from the pregnant woman that the woman is multiparous, there is no ACH, there is no diabetes mellitus. An anthropometric study was carried out: the woman’s height is 167 cm, the woman’s abdominal circumference is 98 cm.
The sum of points according to the proposed table is 5 points. Recommended: conducting childbirth through the natural birth canal. Final diagnosis: Childbirth at 40 weeks of gestation with a large fetus. Chronic placental insufficiency, compensated form. NCD, hypotonic type. H 0 . RIOV. The threat of rupture of the perineum along the old scar. Episiotomy, episiorrhaphy. On December 19, 2011, a boy was born through the natural birth canal, without injuries or deformities, weighing 4450 g, height 56 cm, with an Apgar score of 10 and 10 points.
Example 2. Pregnant M., aged 23, was admitted on September 17, 2012 to the Department of Pathology of Pregnancy with a diagnosis of Edema of a pregnant woman at 38-39 weeks of gestation. Chronic placental insufficiency, compensated form. Large fruit. Chronic pyelonephritis, in remission. CKD 0 . Nonspecific colpitis. NCD, hypotonic type. H 0 . ACO II Art.
From the anamnesis, it was found out from the pregnant woman that the woman is primiparous, there is ACH of the II degree, there is no diabetes mellitus. An anthropometric study was carried out: the height of the woman is 162 cm, the circumference of the woman's abdomen is 100 cm.
The sum of points according to the proposed table is 8 points.
Final diagnosis: Childbirth at 39 weeks of gestation with a large fetus. Edema of a pregnant woman. Chronic placental insufficiency, subcompensated form. Chronic intrauterine fetal hypoxia (CVUGP). Chronic pyelonephritis, in remission. CKD 0 . Nonspecific colpitis. NCD, hypotonic type. H 0 . ACO II Art. Flat fetal bladder. Amniotomy. Threat of rupture of the rigid perineum. Episiotomy, episiorrhaphy. Acute hemorrhoids.
On September 22, 2012, a girl was born through the natural birth canal, without injuries or deformities, weighing 4110 g, height 54 cm, with an Apgar score of 8 and 9 points.
The child was noted asphyxia, mild severity.
Example 3. Pregnant Yu., aged 19, was admitted on May 22, 2011 to the Department of Pathology of Pregnancy with a diagnosis of Chronic placental insufficiency, subcompensated forms at 39 weeks of gestation. HVUGP. Large fruit. NCD, hypertensive type. H 0 . Gestational anemia, moderate. AKO II degree. Diabetes mellitus, type I, moderate course, compensated.
From the anamnesis, it was found out from the pregnant woman that the woman is primiparous, has ACH of the II degree, diabetes mellitus, type I, moderate course, compensated. An anthropometric study was carried out: the height of the woman was 159 cm, the circumference of the woman's abdomen was 120 cm. The sex of the fetus was determined - female and the gestational age on the eve of childbirth - 40 weeks.
The sum of points according to the proposed table is 15 points.
Final diagnosis: Surgical delivery at 40 weeks of gestation with a large fetus. Chronic placental insufficiency, subcompensated form. HVUGP. NCD, hypertensive type. H 0 . Gestational anemia, moderate. AKO II degree. Flat fetal bladder. Clinical narrow pelvis. Amniotomy. Pfannenstiel laparotomy. Cesarean section in the lower uterine segment with a transverse incision.
On May 30, 2011, a girl was born by caesarean section, without injuries or deformities, weighing 4390 g, height 55 cm, with an Apgar score of 10 and 10 points.
This method was used when choosing the method of delivery in 100 pregnant women with a large fetus. The results are presented in table 2.
| table 2 | ||||
| The effectiveness of using the method of choosing delivery in pregnant women with a large fetus. | ||||
| Complications | The method of choosing delivery in pregnant women with a large fetus | Literature data | ||
| Planned caesarean section | Childbirth through the natural birth canal | Planned caesarean section | ||
| 0-8 points | 9 or more points | |||
| SHOP injuries | 5% | 5% | 40% | 5% |
| clavicle fractures | - | - | 15% | 1% |
| cephalohematomas | - | - | 8% | - |
| Intraventricular hemorrhages | - | - | 12% | - |
| Asphyxia, mild | 10% | - | 15% | - |
| Asphyxia, moderate | - | - | 9% | - |
| Asphyxia, severe | - | - | 2% | - |
| Rupture of the pubic joint | - | - | 4% | - |
| Acute hemorrhoids | 15% | - | 18% | - |
| lactostasis | 20% | 15% | 20% | 15% |
| Perineal tear I degree | 20% | - | 23% | - |
| Perineal tear II degree | - | - | 12% | - |
| Perineal tear III degree | - | - | 2% | - |
| Rupture of the cervix of the 1st degree | 10% | - | 16% | - |
| Rupture of the cervix II degree | - | - | 5% | - |
| Rupture of the cervix III degree | - | - | 1% | - |
Information sources
1. Barton J.J., Gabraciak J.A., Ryan CM. The efficacy of X-ray pelvimetry. Am. J.ObstetGyrvec, 1982. - No. 3. - P.304-311.
2. Serov V.N. Problems of perinatal obstetrics. M .: And Obstetrics and Gynecology, 2001. - No. 6. - P.3-5.
3. Blind A.S. Abdominal delivery. L .: Medicine, 1986. - 190 p.
4. Method for determining indications for caesarean section in pregnant women with a transversely narrowed pelvis, RF patent No. 1627116, 1991.
5. Method for choosing the tactics of delivery, RF patent No. 2193198, 2000.
6. Zarubina E.N. Prediction of perinatal outcomes and choice of delivery method. Abstract of the dissertation for the competition. uch. Art. doc. honey. Sciences. - M., 1995.
7. Gautier E.S. The value of cardiotocography in assessing the severity of chronic fetal hypoxia during pregnancy. M .: Obstetrics and gynecology, 1982. - No. 1. - P.9-12.
8. Niswander K., Evans A. Obstetrics: a reference book of the University of California. - M.: Practice, 1999. - 702 p.
9. Baksheev N.S. Contractile function of the uterus. - Kyiv: Health, 1976. - 183 p.
A method for choosing delivery in pregnant women with a large fetus, providing for a scoring of clinical criteria, characterized in that they evaluate the degree of alimentary-constitutional obesity, parity of childbirth, the presence of diabetes, measure the circumference of the abdomen, the height of a woman, find out the woman's age, determine the duration of pregnancy and the sex of the child, each clinical sign is evaluated in points from 0 to 3, in the absence of alimentary-constitutional obesity (ACO), 0 points are assigned, in the presence of ACO degree I, 1 point is assigned, degree II - 2 points, degree III - 3 points, first births are assessed at 3 points, repeated births - 0 points; the presence of diabetes is assessed as 3 points, the absence of diabetes mellitus - 0 points, the abdominal circumference of 98-100 cm is assessed as 0 points, 101-103 cm - 1 point, 104-106 cm - 2 points, more than 107 cm is assessed as 3 points, a woman's height above 166 cm is estimated at 0 points, 163-166 cm - 1 point, 159-162 cm - 2 points, below 159 cm - 3 points, a woman's age 18-23 years old is estimated at 0 points, 24-29 years old - 1 point, 30-35 years old - 2 points, over 35 years old - 3 points; gestational age at 38 weeks is estimated at 0 points, at 39 weeks - 1 point, at 40 weeks - 2 points, at 41 weeks -3 points, the male sex of the fetus is estimated at 2 points, the female sex of the fetus is 0 points, the points obtained are summed up and if the sum of points is less than 9 childbirth is carried out through the natural birth canal, and with a total of 9 or more points, delivery is carried out by caesarean section.
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The invention relates to medicine, namely to obstetrics. To choose the method of delivery in pregnant women with a large fetus, the degree of alimentary-constitutional obesity, parity of childbirth, the presence of diabetes mellitus are assessed, the circumference of the abdomen, the height of the woman are measured, the age of the woman is determined, the duration of pregnancy and the sex of the child are determined, each clinical sign is evaluated in points. In the absence of ACH, 0 points are assigned, in the presence of grade I ACH, 1 point is assigned, grade II - 2 points, grade III - 3 points. The first births are estimated at 3 points, repeated births - 0 points. The presence of diabetes mellitus is estimated at 3 points, the absence of diabetes mellitus - 0 points. Abdominal circumference 98-100 cm is scored as 0 points, 101-103 cm - 1 point, 104-106 cm - 2 points, more than 107 cm is scored as 3 points. A woman's height above 166 cm is estimated at 0 points, 163-166 cm - 1 point, 159-162 cm - 2 points, below 159 cm - 3 points. The age of a woman 18-23 years old is estimated at 0 points, 24-29 years old - 1 point, 30-35 years old - 2 points, over 35 years old - 3 points. The gestational age of 38 weeks is estimated at 0 points, 39 weeks - 1 point, 40 weeks - 2 points, 41 weeks - 3 points. The male gender of the fetus is estimated at 2 points, the female gender of the fetus is 0 points. The scores obtained are summarized, and if the total score is less than 9, childbirth is carried out through the natural birth canal, and if the total score is 9 or more, delivery is performed by caesarean section. The method improves the accuracy of the choice of delivery in pregnant women with a large fetus by analyzing the most significant clinical signs. 2 tab., 3 pr.
Obesity is the excess formation and deposition of adipose tissue in the human body. Usually occurs due to excessive intake of high-calorie foods and low physical activity. Over time, excess food is stored as fat. In our body, fat can be formed not only from fatty foods, but also from protein (meat, fish, eggs) and carbohydrate (sweets, muffins) foods. Obesity is a disease characterized by excessive development of adipose tissue (overweight of more than 20% of the norm).
Obese patients complain of increased appetite, especially in the afternoon, hunger at night, drowsiness, mood instability, irritability, sweating, weakness, shortness of breath. With significant obesity, Pickwick's syndrome develops (hypoxia and drowsiness as a result of poor ventilation of the lungs).
Due to the increased load on the musculoskeletal system, osteoarthritis occurs. Changes in the cardiovascular system are manifested by arterial hypertension. Skin lesions can be manifested by trophic disorders, furunculosis, seborrhea, small pink striae on the hips, abdomen, shoulders, armpits, hyperpigmentation of the neck, elbows and friction points. Women develop various menstrual disorders, infertility; in men, a decrease in potency. There is a high risk of developing type 2 diabetes.
Varieties of obesity
Specialists distinguish alimentary-constitutional, cerebral and endocrine forms of obesity. Causes alimentary-constitutional obesity is a genetic predisposition, constitutional features, systematic overeating, eating disorders (rich night meals for example), a diet high in animal lipids and easily digestible carbohydrates, physical inactivity. Cerebral obesity occurs as a result of traumatic brain injury, intoxication, brain tumors, stress. Endocrine obesity is a manifestation of the pathology of peripheral endocrine glands.
With the alimentary-constitutional form, fatty tissue is distributed evenly throughout the body; with the hypothalamic-pituitary - fat deposits are located more in the face, shoulder girdle, mammary glands, abdomen and limbs; with hypoovarian - in the pelvis and hips.
There are 2 types of general obesity: male (abdominal) and female (gluteal). According to the severity of the development of adipose tissue, 4 degrees are diagnosed: 1 - characterized by an excess of the ideal mass by 20 - 30%; 2 - by 30 - 50%; 3 - by 50 - 90%; 4 - more than 90%.
Obesity occurs in 12% of the population (women are 2 to 3 times more likely than men). Age over 40 increases the risk of developing this condition.
degrees of obesity. Self-diagnosis of obesity
You can determine if you are overweight by calculating your body mass index. Calculating it is quite simple - take your weight in kilograms and divide by your height squared in meters. With normal body weight, the body mass index is 18.5 - 24.5. With obesity of the 1st degree, the body mass index is 30 - 35. With obesity of the 2nd degree, the body mass index is 35 - 40. With obesity of the 3rd degree, the body mass index is more than 40.
A simple approximate method for diagnosing obesity is to determine the thickness of the fat fold in the epigastric region (normally 1 - 1.5 centimeters, with obesity - more than 2 centimeters).
For example, with a height of 1 meter and 75 centimeters and a weight of 80 kilograms, the body mass index is 80 divided by 1.75 squared. This will be equal to 26.12. It turns out that there is either a slight excess weight or a person has an optimal physique, but obesity is still far away. True, this method of determining the ideal weight does not pay attention to the difference between the male and female figure, as well as the percentage of adipose and muscle tissue in the body. People who play sports and have a muscular build will have the same body mass index as people who already have a little body fat. However, body mass index remains the only recognized international criterion for assessing excess weight. For objectivity in determining the optimal proportions, it is necessary to pay attention to various data.
Obesity is a chronic problem, over time, "thanks" to it, such diseases develop: diabetes mellitus, hypertension, myocardial infarction, cholelithiasis, varicose veins, arthrosis of the joints.
Causes of obesity
Obesity develops as a result of an imbalance between the amount of energy entering the body and expended during the day. People who are prone to weight gain usually receive much more energy than they expend. Excess energy accumulates and is deposited in the form of subcutaneous and internal fat. There are a number of reasons that contribute to the development of obesity: a sedentary lifestyle, genetic factors (heredity), disruption of the endocrine glands, a tendency to stress, constant lack of sleep, often using various diets.
obesity treatment
It is necessary to treat obesity in a complex. Be sure to include a certain diet and increase physical activity. A balanced low-calorie diet is recommended. .Limit energy intake to 1200 - 1500 kilocalories per day. Easily digestible carbohydrates, fats of animal origin are limited in the diet (at least 50% of lipids should be of vegetable origin), table salt up to 5 grams per day, liquid up to 1 - 1.5 liters per day. The diet should include 90 - 120 grams of protein, 40 - 80 grams of fat, 100 - 120 grams of carbohydrates and a sufficient amount of vitamins and minerals. For the treatment of obesity, foods high in fiber are recommended. contributing to rapid saturation. Food fractional, 5 - 6 times a day. Fasting days are held 1 - 2 per week: protein (cottage cheese - 5 grams of cottage cheese per day; meat - 250 - 350 grams of boiled meat or fish), carbohydrate (apple - 1.5 kilograms of apples and rice porridge from 75 grams of rice and 450 grams of milk; curd-kefir - 400 grams of cottage cheese and 700 milliliters of kefir). Complete fasting is possible only in a hospital setting or after preliminary self-training.
With increased appetite, anorexigenic drugs are prescribed: fepranone, teronnac, deopimone, fenfluramine. The course of treatment is about 1 - 1.5 months. Since this group of drugs has a stimulating effect, it is recommended to use them in the morning. To stimulate lipolysis, adiposin, metformin are prescribed. In the initial period of treatment, it is possible to use diuretics: hypothiazide, furosemide or herbal preparations (buds and birch leaves, horsetail and others) - for 1 to 2 weeks. 3 - 4 degree of obesity, the initial manifestations of Pickwick's syndrome are indications for surgical treatment.
To enhance metabolic processes in alimentary obesity, cold procedures are prescribed - wet rubdowns of the body, douches, cool showers, contrast baths.
With alimentary obesity without violations of the cardiovascular system, thermal procedures are indicated.
1. Light and heat baths (55 - 60 C), for 10 - 15 minutes, every other day.
2. General wet wraps lasting from 45 to 60 minutes, followed by a rain shower 36 - 37 C.
3. Thermal baths - hot fresh baths, baths with a temperature rising from 35 to 41 C and hot dry air baths.
4. Finnish sauna or Russian steam room.
To improve the function of the endocrine, nervous, cardiovascular and digestive systems, mineral waters are used in the form of baths, bathing in a mineral water pool, ingestion and intestinal lavage. Sulfide, carbonic, radon, chloride baths are used.
Treatment of obesity should be carried out for a long time, within 1 - 2 years. Body weight should decrease gradually. A rapid, significant decrease in it in the case of the return of the patient to the previous way of life gives the opposite effect.
Among the physical methods of rehabilitation, physiotherapy is of great importance in the treatment of obesity, morning hygienic exercises, dosed walking, sports exercises (running, rowing, swimming, cycling), outdoor and sports games are used. It is advisable to use occupational therapy and general massage.
An obesity treatment program must be developed individually for each person based on the state of health and the reasons that caused this problem. Someone needs to pay more attention to nutrition, and someone needs to activate their own physical activity.
You can learn more about the different ways to lose weight here Weight Correction
Additional articles with useful information
Optimal weight - what is it?Having started to lose weight, a person faces many difficulties, and one of them, which is most often forgotten at first, is what is my ideal weight to strive for.
Physical exercises that activate fat metabolismTo combat excess weight, you need to use many tools, and one of them, without which it is almost impossible to do, is physical exercises that burn fat.
E66 Obesity
Epidemiology
Since 1980, the number of obese people in parts of North America, the UK, Eastern Europe, and the Middle East has tripled. Obesity rates in the US increased by 100% over the same period. The African continent (south of the Sahara) is the only region in the world whose inhabitants do not suffer from obesity.
According to the WHO, as of 2014, more than 600 million adults worldwide are obese (which is 13% of the population). It is more commonly seen in women.
But of particular concern to experts from the International Association for the Study of Obesity (IASO) is the increase in the number of obese children. Nearly 42 million children under the age of five are either overweight or diagnosed with grade 1, 2 or 3 obesity. The highest rates of childhood obesity risk are in Malta and the United States (25%), and the lowest in Sweden, Latvia and Lithuania.
Even in Africa, the number of children in this age group who are grade 1 overweight or obese has nearly doubled, from 5.4 million in 1990 to 10.6 million in 2014.
About half of these children live in Asian countries. For example, in China, every tenth urban child is obese. This is attributed to the increased consumption of carbohydrates, not fats.
Causes of obesity 1 degree
Obesity is a complex heterogeneous disease and is increasingly being referred to as the metabolic syndrome. Exogenous and endogenous risk factors for its development consist of excessive dietary intake (unused energy is stored in the body as fat), physical inactivity (lack of calorie-burning physical activity), endocrine disorders, genetic mutations, and family (hereditary) predisposition.
With overeating and hypodynamia, everything is clear. Moreover, the expenditure of energy that food gives a person is of decisive importance, because, as it turned out, muscle loads contribute to the release of the membrane protein FNDC5 (irisin) from the skeletal muscle tissue. It has been experimentally proven that irisin can regulate the participation of visceral adipose tissue and subcutaneous adipose tissue in thermogenesis, that is, it behaves like the hormone adiponectin produced by white adipose tissue cells and involved in the regulation of glucose levels and the breakdown of fatty acids.
The key causes of obesity of the 1st degree lie in metabolic disorders of white adipose tissue, the excess of which is characterized by this pathology. Adipose tissue is formed by adipocytes, which are enlarged in obesity due to an increased level of triacylglycerol (TAG) accumulated in them.
Two main processes occur in adipose tissue: adipogenesis (lipogenesis) - cell differentiation, as a result of which preadipocytes become full-fledged fat cells, and lipolysis - the breakdown of TAG contained in adipocytes. The products of this breakdown in the form of fatty acids are released into the vascular system for use as energy substrates.
Since white adipose tissue can normally perform its functions (TAG accumulation and its remobilization) with a balance of both biochemical processes, the pathogenesis of obesity is associated with dysregulation of this balance. As a rule, this is a decrease in the intensity of lipolysis, which is regulated by numerous hormones, enzymes and polypeptide mediators.
The breakdown of triacylglycerol requires specific lipolytic (hydrolase) enzymes present in adipose tissue (ATGL, HSL, MGL) and encoded by certain genes. The body may lack these enzymes. Deficiency of the already mentioned hormone adiponectin also leads to obesity, for the sufficient synthesis of which the ADIPQTL1 gene is responsible. In the accumulation of excess fat mass, malfunctions in the FTO gene, which encodes dioxygenase enzymes of the hydrolase family that catalyze the breakdown of TAG, may be to blame. Any mutations and polymorphisms of these genes can cause a deficiency of substances that ensure the metabolism of fat cells. For example, people with two copies of the FTO gene allele weigh an average of 3.5 kg more and have a higher risk of developing obesity and type 2 diabetes.
A similar role was played by the discovery of the amino acid peptide ghrelin (secreted in the stomach and proximal small intestine), which increases appetite, glucose oxidation, and lipogenesis. Ghrelin is the only substance that is released in response to a decrease in the content of the gastrointestinal tract and is suppressed when it is replenished in the process of eating. Already in grade 1 obesity, as in patients with insulin resistance, ghrelin levels are chronically low. At the same time, visceral adipose tissue is more sensitive to ghrelin deficiency than subcutaneous adipose tissue, which means that lipid deposition will occur predominantly in visceral fat depots. A relationship between ghrelin deficiency and mutations in the G274A and GHS-R genes has been identified.
In addition, common causes of obesity of the 1st degree are endocrine disorders such as increased production of the enzyme lipase and the hormone insulin by the pancreas, insufficient levels of thyroid hormones (triiodothyronine). For example, when blood glucose levels rise, endogenous insulin not only lowers it, but at the same time inhibits the secretion of the pancreatic counter-regulatory hormone glucagon, one of whose functions is to stimulate lipolysis. So insulin actually prevents glucagon from fighting fat.
An equally important role in the pathogenesis of obesity is played by certain pathological changes in the functioning of certain brain structures, in particular the anterior pituitary gland (adenohypophysis). So, the breakdown of TAG is prevented by a low level of the lipolysis-stimulating hormone somatotropin and increased production of adrenocorticotropic hormone (ACTH). Due to excess ACTH, the adrenal cortex begins to produce more cortisol, which leads to an increase in blood sugar and inhibition of the breakdown of triacylglycerol.
Sex steroids (estrogen, testosterone), somatomedin (IGF-1, insulin-like growth factor-1), catecholamines (adrenaline, receptors of which are found in adipose tissue) are directly related to the process of accumulation and splitting of adipose tissue cells. They are triggers of G-protein receptors, and their signals (passing through the adenylate cyclase signal transduction system) affect the activation of lipolytic enzymes in adipose tissue.
Obesity of the 1st degree is often observed in schizophrenia and schizoaffective disorders, prolonged depression, as well as in bipolar and panic disorders of the psyche and agoraphobia (fear of open spaces and crowded places).
Medical obesity can be provoked by atypical antipsychotics, tricyclic antidepressants, hypoglycemic agents of the thiazolidinedione group, sulfonylurea drugs, steroids, certain anticonvulsant drugs and hormonal contraceptives.
Symptoms of obesity 1 degree
The first signs of obesity are extra pounds. A person's weight is considered normal with a body mass index (BMI) of 18.5-25. BMI is usually expressed in kilograms per square meter (kg/m2) and is calculated by dividing a person's weight by the squared height.
What is the easiest way to calculate it? Divide your weight in kilograms by your height in meters, and then divide the result once again by your height. For example: if you weigh 70 g and are 1.75 m tall, you need to divide 70 by 1.75. Answer 40. Then we divide 40 by 1.75 and get the body mass index - 22.9 (22.85). This is an excellent, that is, a healthy BMI!
Weight is considered simply overweight when the BMI is 25-30, and a BMI of 30-35 indicates obesity of the 1st degree.
According to endocrinologists, in the absence of complications, the symptoms of obesity of the 1st degree do not appear until the transition from the initial stage to the progressive one. Then there may be heaviness in the stomach, belching, flatulence, headaches, shortness of breath with tachycardia, attacks of weakness and hyperhidrosis.
In general, the specifics of symptoms are determined by the types of obesity, which endocrinologists distinguish depending on the cause into exogenous and endogenous. And all of the above applies to primary obesity, that is, developing due to overeating and physical inactivity. This type of excess accumulation of adipose tissue has such variants of the name as alimentary obesity of the 1st degree, or alimentary-constitutional obesity of the 1st degree, or exogenous-constitutional obesity of the 1st degree.
All other causes of obesity are endogenous (see the previous section), and pathology can be diagnosed as endocrine (hormonal, pituitary, hypothyroid, diabetic, etc.), cerebral (hypothalamic) or hereditary obesity. In a word, the division of obesity into types does not differ in strict unification.
And according to where fat accumulates, types of obesity are distinguished: abdominal (other terms - upper, central, android or male) with a characteristic increase in the volume of adipose tissue in the abdominal region (on the abdomen) - both under the skin and due to visceral (intra-abdominal) ) fat; femoral-gluteal (female or gynoid); mixed (most common in endocrinopathies).
Clinical practice has shown that obesity of the 1st degree of abdominal type has more serious complications.
Obesity 1 degree in women
Describing obesity of the 1st degree in women, it should be noted the most important role of sex hormones in the regulation of energy balance. First of all, this is the ratio of androgens and estrogens.
Even with a relatively normal diet, women may have problems with the regulation of adipose tissue homeostasis. So, with a predominance in the direction of testosterone, hyperandrogenism develops, often associated with increased accumulation of visceral fat; the same happens in cases where women have polycystic ovary syndrome, and during menopause.
Why is normal estrogen levels so important? Because the female ovarian sex hormone can activate the synthesis of the pituitary neuropeptide alpha-melanocyte-stimulating hormone, which induces a number of catabolic effects, including the breakdown of fat accumulations. In addition, the action of estrogens in the hypothalamus increases the local activity of leptin, which inhibits food intake and increases energy expenditure.
Obesity 1 degree during pregnancy can occur as excessive gestational weight gain. Pregnant women recover by 10-18 kg, and this is due to hormonal changes in the body and the biological and physiological needs of this condition. However, obesity of the expectant mother significantly increases the risk of intrauterine fetal pathologies and various obstetric complications.
Obesity 1 degree in men
Over the past 25 years, obesity of the 1st degree in men aged 20 years and older has become a problem for 15-18% of the male population of developed and developing countries.
This is obesity of the 1st degree according to the abdominal type - with a fat belly and a swollen waist, the fat layer in the armpits and the pleural girdle is also significantly thickened.
The thicker the waist in men after 30 years, the lower the level of testosterone in the body: according to foreign researchers, an increase in waist circumference by 10-12 cm reduces the production of male sex hormone by 75%, which leads to the development of erectile dysfunction. Whereas the natural aging process reduces testosterone levels by an average of 36%. The reason for this is explained by the fact that adipose tissue produces estrogens (as mentioned above). At the same time, the reproductive function of a man also suffers due to a low number of spermatozoa and a decrease in their mobility.
Many experts identify the syndrome of hypoventilatory obesity (OHS) in men, which combines grade 1 obesity, hypoxemia (decrease in blood oxygen levels) during sleep, hypercapnia (increased carbon dioxide in the blood) during the daytime - as a result of too slow or shallow breathing ( hypoventilation).
A frequent companion of obesity in men is kidney stones, benign prostatic hyperplasia, urinary incontinence, as well as changes in the metabolism of sex hormones that can trigger the development of prostate cancer.
By the way, how are obesity of the 1st degree and the army combined? There is no obesity in the list of diseases attached to the order of the Ministry of Defense "On military medical examination in the Armed Forces of Ukraine", so the suitability or limited suitability of an obese guy for military service is determined on an individual basis.
Obesity 1 degree in children
Depending on age, gender and constitutional features, the body weight of healthy children varies. A one-year-old child can weigh 9-12 kg with a height of 70-80 cm.
Obesity of the 1st degree in children is diagnosed when their weight exceeds the average age norm by 20-25%. And chronic overeating can be observed already in a two-year-old child.
So, obesity can be in a one-year-old baby with a body weight of more than 12-13 kg; at the age of three - more than 18 kg; in five-year-olds - more than 24-25 kg; at seven years - over 30-32 kg; at 10 years old - more than 45-47 kg, and at 16 - over 85 kg.
Domestic pediatricians are sure that the main causes of childhood obesity are associated with excessive and malnutrition (especially the habit of sweets, sweetened drinks and snacks), which disrupts metabolism, and a sedentary lifestyle, and endocrine or cerebral problems cause a fairly low percentage of obesity. 1 degree in children.
Indeed, according to medical statistics, in 93% of cases, obesity in a child is recognized as idiopathic, that is, occurring for an unknown reason. Only 7% of cases are associated with hormonal or genetic factors. And more often than other hormone-deficient conditions, hypothyroidism and a lack of growth hormone are noted. And the so-called syndromic obesity, diagnosed with congenital Cushing, Prader-Willi, Bardet-Biedl or Pehkranz-Babinski syndromes, is very rare.
Genetics plays a significant role in the development of childhood obesity: according to some data, 80% of children whose parents are obese also have a significant excess body weight.
But it is impossible to completely exclude the influence of hypothalamic and pituitary disorders on the mechanism of development of obesity in children. In adolescence, mostly in girls, the initial degree of endogenous obesity may be a sign of the hypothalamic syndrome of puberty (pubertal dispituitarism) - one of the types of hormonal imbalance of the hypothalamic-pituitary-adrenal axis and general metabolism. Fat reserves are localized according to a mixed type - on the buttocks, thighs, chest, shoulders, and strip-like atrophoderma (striae) appears there.
Complications and consequences
In order to have a general idea of what consequences and complications an excess of fat in the body entails even with obesity of the 1st degree, it is enough to note an increase in the level of low-density cholesterol (LDL) in the blood and the development of atherosclerosis, hypertension, heart failure, coronary heart disease and etc.
Obesity impairs the body's response to insulin and increases blood glucose levels: excess fat is at the root of 64% of diabetes in men and 77% of cases in women.
In addition, as a result of obesity, there may be: obstructive sleep apnea, cholelithiasis and urolithiasis, gastroesophageal reflux disease, fatty liver disease and fatty pancreatic necrosis, chronic renal failure, degenerative-dystrophic joint pathologies, lymphangiectatic edema of the lower extremities, menstrual disorders and infertility in women , erectile dysfunction in men.
And this is not a complete list of health problems that lead to obesity of the 1st degree. British Heart Foundation experts link at least ten types of cancer that develop with overweight.
And obesity in childhood and adolescence is associated with an increased risk of developing obesity in adulthood (up to 41-63%), with concomitant long-term health risks.
Diagnosis of obesity 1 degree
The diagnosis of obesity of the 1st degree begins with weighing, measuring height (to calculate BMI), as well as determining the ratio of the circumference of the waist and hips (which allows you to clarify the localization of body fat).
To determine the volume of adipose tissue and its distribution, instrumental diagnostics are performed using fluoroscopic absorptiometry (DEXA), ultrasonic densitometry, and MRI to detect the amount of visceral fat.
Differential Diagnosis
Differential diagnosis is necessary to identify possible pathologies: hypothyroidism, polycystic ovaries (or Stein-Leventhal syndrome in women), a tumor of insulin-producing cells of the pancreas (insulinoma), a congenital tumor of the pituitary gland in children (craniopharyngioma), etc.
Treatment of obesity 1 degree
To date, dietary changes—a calorie-reduced diet for obesity grade 1—and exercise are the accepted treatments for grade 1 obesity.
Nutritional quality can be improved by increasing the intake of dietary fiber and reducing the intake of high-calorie foods such as fats and carbohydrates. But at the same time, the diet should contain foods that contain all the necessary vitamins, micro- and macroelements. The ultimate goal is to lose up to 5-10% of the weight.
How to lose weight with obesity of 1 degree, see for more details - Diet 8 for obesity. The same publication contains a list of foods to be avoided and an approximate diet menu for grade 1 obesity.
Dietary changes are also effective in limiting excessive weight gain during pregnancy.
Along with diet and exercise, drugs can be used in the treatment of obesity, in particular, Xenical, a drug that suppresses lipase and reduces intestinal absorption of fats (other trade names Orlistat, Orlimax, Orsoten). This pharmacological agent is taken three times a day - one capsule before each meal. But it is contraindicated for use in the presence of kidney stones and an increased content of oxalates in the urine, with pancreatitis, cystic fibrosis and celiac disease. Possible side effects include nausea, diarrhea, flatulence, headaches, and sleep disturbances.
Surgical treatment
If diets, exercises, behavioral therapy and pharmacology fail, resort to the last resort and perform surgical treatment with bariatric surgery. This treatment is strictly indicated and is not intended for those who believe that they are simply overweight. As a rule, indications for surgical treatment of obesity occur at a BMI above 40. However, if the patient has such problems as type 2 diabetes, hypertension, varicose veins and problems with the joints of the legs, the indications already appear at a BMI of 35.
Surgical intervention is in the form of:
- introduction of an intragastric balloon to reduce the volume of the stomach;
- gastric bypass, in which it is divided into two separate "compartments" of different sizes, leaving only a smaller part in a functioning state;
- bandage on the stomach, which slows down the progress of food;
- sleeve gastroplasty (vertical excisional gastrectomy).
With obesity of the 1st degree, gastroplasty is mainly used, during which part of the stomach is removed, and a long and rather thin “sleeve” is formed from the rest. The capacity of the stomach in this case decreases by about 10 times (up to 150-200 ml).
Alternative treatment
Among the folk remedies for obesity, green tea and celery root are recognized as the most effective. Tea can boost your metabolism and fat oxidation, and by stimulating your nervous system, it can make you move more and burn more calories. And digesting celery root dishes requires a lot of energy.
Treatment with herbs that have diuretic and laxative effects is strongly discouraged by doctors. But in order to slightly dampen the appetite, herbalists advise eating plantain leaves. Plantain contains fibers that completely fill the volume of the stomach, which contributes to a feeling of satiety, and also normalizes blood glucose levels. In addition to plantain leaves, you can use kelp seaweed, which enhances the thyroid gland, dulling the feeling of hunger.
In the article we discuss obesity of the 1st degree. We list the causes of weight gain, types, stages of the disease. You will learn how to calculate BMI, recognize pathology at the initial stages. We will also pay attention to prevention methods and a special diet.
Obesity of the 1st degree is the accumulation of excess body weight in the form of subcutaneous fat. This pathology is diagnosed with an increase in weight by 20% of the average. According to medical statistics, women are more susceptible to it by 50% than the representatives of the stronger sex. The peak of pathology development falls on the age from 30 to 60 years.
Treatment should include changes in eating behavior
The main reason for the formation of the disease is an imbalance between the number of calories entering the body and their consumption. The excess amount of fats, carbohydrates is converted into fat cells, which are deposited in the subcutaneous layer.
Overeating, disturbed eating behavior leads to alimentary obesity. Excessive, systematic consumption of large amounts of food provokes the replenishment of the fat depot. Also, the cause of the disease is impaired metabolism (5% of cases). At the same time, metabolism decreases, hormonal disorders occur.
Genetic predisposition, disruption of the endocrine system (insulinoma, hypothyroidism, Itsenko-Cushing's disease) can provoke weight gain.
Disorders of the nervous system can also give impetus to the development of the disease: stress, depression, insomnia make psychological discomfort "jam".
Types and stages of pathology
According to the nature of body fat, their localization, the following types of obesity are distinguished:
- femoral-gluteal- fat cells are formed mainly in the lower part of the body. This type is more common in women. The body becomes pear-shaped. Accompanied by disorders of the veins of the lower extremities, joints, spine.
- Abdominal- characterized by accumulation of fat in the upper body. The abdominal region suffers the most. The figure takes on a spherical shape. This type of obesity is more common in men. Pathology is associated with the development of diabetes mellitus, stroke, arterial hypertension.
- Intermediate (mixed) type- characterized by an even distribution of body fat throughout the body.
According to the rate of growth of the layer, progressive and gradually increasing obesity are distinguished. There are stable and residual stages of the disease. In the stable phase, the primary weight gain occurs, in the residual phase, this is the result of a sharp weight loss.
Allocate primary, secondary, endocrine species. The primary include pathologies caused by eating disorders, the secondary - based on genetic, hereditary diseases. The endocrine type is formed due to violations of the endocrine glands.
How to calculate BMI
Body mass index (BMI) is used to classify the degree of obesity. To calculate it, you need to divide the patient's weight (kg) by the square of height.
First signs and symptoms
The main symptom of the disease is a change in the patient's appearance. Typical places for putting off extra pounds are the stomach, hips, buttocks, neck, shoulders. Excess weight begins to cause dissatisfaction with their own appearance in patients. Against this background, depressive disorders, increased irritability, and apathy are often formed.
Due to the increased load on the internal organs, failures of most body systems occur. Most often, the gastrointestinal tract suffers. There are heaviness in the abdomen, nausea, constipation.
Strongly increased weight provokes disorders of the musculoskeletal system. The patient may feel pain in the muscles, joints. Peripheral edema appears.
For women, menstrual irregularities are typical. In later stages, this can lead to amenorrhea.
Due to endocrine disorders, the condition of the skin and hair worsens. Severe sweating appears, oiliness of the skin increases, the risk of developing skin diseases (eczema, furunculosis, pyoderma) increases.
Diagnostics
If you notice something is wrong, you will need to consult various specialists (therapist, nutritionist, endocrinologist). It also does not hurt to go to a psychologist.
When diagnosing, a complete anamnesis is collected. The doctor draws up a genetic map, determines the minimum / maximum BMI, the duration of the period of weight gain. Particular attention is paid to the lifestyle, nutrition of the patient.
For successful diagnosis with the subsequent choice of treatment, important attention is paid to the calculation of the body weight index. Among the necessary characteristics, the coefficient of distribution of adipose tissue is used. It is calculated based on the ratio of the circumference of the waist to the circumference of the hips. The abdominal type of the disease is indicated by indicators exceeding 0.8 units for women and 1 for men.
Additionally, ultrasound, MRI, CT are prescribed. Studies allow you to more accurately determine the location and size of body fat. By means of a blood test, the level of triglycerides, uric acid, cholesterol, lipoproteins is determined. Be sure to determine glucose tolerance in order to exclude the development of diabetes.
Treatment Methods
A nutritionist can help you create the right diet
The success of treatment directly depends on the desire of the patient. Therefore, the competent work of a psychologist is important. A nutritionist develops an optimal nutrition system for the patient, an exercise therapy instructor selects physical exercises to keep the body in good shape.
With the ineffectiveness of the diet for 12 days, they resort to medical intervention. Patients are prescribed drugs from the amphetamine group. They contribute to the rapid appearance of a feeling of satiety after eating.
If necessary, the doctor may prescribe fat-mobilizing drugs in combination with antidepressants (Adiposin, Fluoxetine). Drugs regulate eating behavior, help facilitate the process of weight loss.
Diet
Diet food is to reduce the calorie content of food by 300-500 Kcal. The main restriction falls on carbohydrate foods, animal fats. Preference is given to boiled, steamed or stewed food. At the same time, it is important to consume a sufficient amount of clean water - at least 1.5 l / day. Food is taken in small portions 5-6 times a day.
The basis of dietary nutrition is non-starchy vegetables, lean meats and poultry, cereals, fruits. Spicy, fried, salty foods, alcohol fall under a strict ban.
Prevention
To successfully prevent obesity, it is enough to monitor the balance of calories consumed and expended. To do this, you should adhere to proper nutrition, observe minimal physical activity (sports).
With a predisposition to the disease, special attention must be paid to nutrition. Simple carbohydrates and fats should be excluded or limited. The emphasis in nutrition is best done on fiber, protein, plant foods.
For the prevention of the disease, the control of specialists is important. Once a year it is necessary to visit an endocrinologist and a nutritionist.
What to remember
- If obesity of the 1st degree is suspected, the patient needs to consult a therapist, nutritionist, endocrinologist, psychologist.
- Due to the increased load on the internal organs, failures of most body systems occur.
- For successful prevention, it is enough to monitor the balance of calories consumed and expended.
Many women are faced with the problem of excess weight, considering it just an external disadvantage. But at the time of planning and the course of pregnancy, special attention must be paid to this factor. A little extra weight is not a serious problem or threat to the proper development of the child. Dangerous is the moment when simply being overweight turns into an NZhO of 1 or more degrees.
In medicine, this term stands for a violation of fat metabolism in the body, to put it simply, obesity. This problem is becoming more common among people from different countries, preventing them from leading a normal healthy lifestyle. Obesity during pregnancy leads to many problems and complications.
The rise of obesity
This pathology occurs for various reasons and can develop even in childhood. The main problem is that the majority of people suffering from NZhO do not consider it necessary to take measures to get rid of excess weight. Obesity can occur for the following reasons:
The most common cause of weight gain is a sedentary lifestyle, junk food, frequent drinking of alcoholic beverages, smoking and overeating. In such cases, the person himself admits the occurrence of a health problem due to a negligent attitude.
To avoid overeating, you need to listen to your body. The part of the brain - the hypothalamus, gives a signal when the body needs food and also at the moment of saturation. With a normal diet, a person stops eating when they feel they are full. With systematic overeating, this part of the brain ceases to give signals to the body about a sufficient amount of food, and also causes a person to feel hungry much more often. This leads to the fact that the body constantly receives more and more calories that it does not require. It is impossible to spend such an amount in a short period of time even with physical exertion, if any. So a person gets used to taking the amount that far exceeds the required rate, which leads to the deposition of fatty tissues. If you are overweight from overeating, you can quickly get a Grade 1 NZhO, especially during pregnancy, when your appetite is increased.
During pregnancy, women who are overweight and predisposed to obesity need strict weight control and an individual diet. During this period, it is important to provide the body with the right amount of nutrients, limiting the amount of simple carbohydrates and fats. When following the recommendations of a specialist for the period of bearing a child, you can gain a minimum weight or, conversely, even get rid of excess. You can not sit on strict diets and load yourself with physical exercises. In order not to aggravate the problem of obesity, it is enough to eat right and not overeat.
The impact of obesity on the human body
Violation of fat metabolism is a pathology due to which an excessive amount of fat deposits accumulate in the body. This leads to increased work of all organs, as they experience an increased load.
Obesity causes both physical and psychological problems. Excess weight disrupts the normal functioning of most organs, leading to pain, shortness of breath, problems with blood pressure, swelling, disruption of the cardiovascular system and other more serious consequences. Also, self-esteem of a person suffers from obesity even of 1 degree, complexes and depression appear, which very often interferes with personal life, professional career and normal development.
This pathology has a negative impact on the reproductive function of a person, so an obese woman may have problems conceiving a child. Doctors draw a direct link between obesity and infertility, because due to a violation of the normal functioning of the body, various pathologies of internal organs occur. Being overweight can lead to problems with conceiving a child, but if they are avoided, then complications may arise during the period of gestation or childbirth.
At the time of pregnancy, a woman's hormonal background changes greatly, the hormone progesterone and gonadotropin are produced in excess in the body. They provide a favorable environment in the body for increased deposition of fatty tissues. This process is inevitable in all women, even if they were not overweight before pregnancy. Fat deposits are necessary as protection for the fetus, so their largest accumulation occurs in the chest and abdomen, as well as the buttocks and thighs.
In the presence of obesity in a woman, it is necessary to reduce the increase in body weight as much as possible so that the body uses the already existing fat deposits. This requires the preparation of an individual nutrition plan, which can only be done by a specialist. Diet can be detrimental to fetal development if it does not include all the necessary nutrients.
Carrying a child with 1 or more degrees of obesity
If a woman is obese of the 1st degree, then this practically eliminates the risk of pathologies and problems with the development of the fetus. It is necessary to carefully monitor your well-being and nutrition, take tests in a timely manner and undergo an examination with a doctor. With grade 1 NJO during pregnancy, as a rule, there are no problems with the woman's health. Childbearing and childbirth most often pass without complications. Also, the pathology of a woman's body weight is not the cause of any defects in a child.
In the presence of obesity of 2 or more degrees, the risk of complications increases greatly. First of all, this refers to the health and condition of the expectant mother. During pregnancy, the organs perform work 2 or more times more actively than in the normal rhythm of life.
Obesity increases the load even more, which can cause such complications:
Preeclampsia is a severe form of preeclampsia that occurs in late pregnancy. This is a very common complication in obesity of 2 or more degrees. At the time of development of this pathology, the fetus does not receive all the necessary nutrients and oxygen, which leads to serious consequences. It is manifested by a high protein content in the urine of a pregnant woman, an increase in blood pressure, rapid weight gain and edema.
Obesity can also cause other complications. The state of health of the mother directly affects the well-being and development of the fetus. Often, VVT leads to the fact that the child is already born with overweight. Which is a serious complication for the mother at the time of labor and for the child himself. Most often, with such a pathology, it is necessary to resort to surgical intervention, as well as to constant monitoring of the child's condition by specialists.
A lack of folic acid can also be a consequence of obesity, more precisely, impaired metabolism. Even when taking special preparations, this substance may not be absorbed in the body of a woman, which leads to its deficiency for the normal development of the child's nervous system.
Childbirth in obesity and disease prevention
Women with overweight and 1 degree of obesity most often give birth on their own, without experiencing any difficulties. This is possible with proper management of pregnancy and the size of the fetus and pelvis of the woman for natural childbirth. At this stage of NZhO, labor activity is not greatly reduced, which allows a woman to cope with the process on her own, avoiding surgical intervention.
If a woman in labor has a degree of pathology of 2 or more, then there is a risk of a caesarean section and forceps to improve the process. This is due to the fact that obesity disrupts the functioning of the part of the brain that is responsible for labor. It is because of this that one can be afraid of overcarrying the child, as well as very low labor activity. With such complications, the fetus experiences oxygen starvation, which requires urgent medical attention.
When giving birth naturally, heavy bleeding can occur, which is also a consequence of being overweight. In addition, there is a high risk of developing diabetes in the mother immediately after childbirth. That is why women with overweight problems need to examine the blood for sugar after childbirth and also after stopping breastfeeding.
Caesarean section in such cases is the safest way to have a baby. When it is carried out, there is no risk to the fetus, and it is possible to avoid most complications for the woman herself. But when suturing and healing, inflammation can occur due to an excess amount of adipose tissue.
If a woman suffers from NJO, it is necessary to constantly be under the supervision of a specialist. Pregnancy during this period is not contraindicated, but you need to be responsible for your well-being and health.
Proper nutrition, a moderately active lifestyle, giving up bad habits and taking the necessary vitamin complexes will help to avoid complications and gain fat mass. Being overweight is a very common problem, but having it does not mean that a woman cannot become pregnant and give birth.