The effect of maternal weight on Misoprostol Induction of labour at Rahima Moosa Mother and Child Hospital

Tsekeli, Matefo Eileen
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Background: Maternal obesity has become an epidemic that obstetricians manage daily. Obese women not only face long-term chronic medical conditions but they are also at an increased risk of developing maternal and neonatal adverse outcomes. In South Africa the proportion of reproductive age women who are overweight or obese is around 75%.This results in a large number of overweight or obese women requiring induction for pregnancy related medical conditions. Methods: This was a retrospective comparative study looking at all normal,overweight and obese women who underwent induction of labour with oral misoprostol and their outcomes at Rahima Moosa Mother and Child Hospital between 01 July 2017 to 31 October 2017.Results: The study included 185 women. Thirty-eight women had a normal BMI, 61 were overweight and 86 women were classified as obese. Of the medical conditions evaluated in the study participants, only gestational hypertension (p=0.02) and gestational diabetes (p=0.02) suggested a significant difference between the normal, overweight, obese groups. In this study there were only 11 cases of failed induction of labour (5.9%). Seven of the 11 (8.1%) were found to be in the obese group. A total of 56.8% (n=105) of participants gave birth vaginally (NVD) and 43.2% (n=80) had a caesarean section performed. There was no significant difference (p=0.22) seen between the different BMI categories and the delivery outcomes observed. Seventeen babies were admitted to NICU, six in the obese group, seven in the overweight group and four in the normal BMI group. There was no statistical significant difference noted in the various BMI groups (p=0.19). Conclusion: This study yielded a minimal difference between those who achieved normal vaginal delivery and those who had caesarean section between normal, overweight and obese women. Gestational hypertension and gestational diabetes were the only two conditions yielding a statistically significant difference in all the three BMI groups
A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfillment of the requirements for the degree of Masters in Medicine, 2021