Monday, July 14, 2008

Too Fat and Pregnant

“The offices of Dr. Mark Chames, an obstetrician at the University of Michigan Health System in Ann Arbor, are outfitted with some special equipment. The blood-pressure cuffs used on patients’ arms are actually thigh cuffs, originally designed to strap around a leg. Standard scales, which measure up to 350 pounds, have been supplemented by ones that accommodate 880 pounds. Before the new scales arrived, some patients were weighed at the hospital loading dock. After decades in which the obesity epidemic spread to every demographic group in the nation, it has also ended up here: the maternity ward. One in five women who give birth in the U.S. is obese, according to Susan Chu, an epidemiologist at the Centers for Disease Control and Prevention. And doctors are seeing more pregnant women who are morbidly obese, weighing 400, 500, even 600 pounds. Excess weight makes pregnancy riskier: obese women are more likely to develop hypertension and diabetes, and to deliver prematurely. The need to manage their conditions, and to meet their logistical needs, is giving rise to a new medical subspecialty, what some are calling ‘bariatric obstetrics.’ Chames, who already sees at least a dozen morbidly obese pregnant women each month, will direct his hospital’s new Center for Bariatric Obstetric Care when it opens later this summer.”

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