[Obesity in pregnant women as a problem in obstetrics].

Obesity, one of the most common civilization diseases, is currently one of the major health problems in the society. It is estimated that in industrialized countries excessive weight appears in more than 30% of adult population, with adult women comprising 50% of the group. Considerable amount of attention is paid to the course, delivery and puerperium in women with excessive weight and obesity during pregnancy. A close correlation to fetal macrosomia, increased ratio of caesarean sections and perinatal death of fetuses has been indicated in this group. Spontaneous birth increases the risk of shoulder dystocia and brachial plexus injury in newborns. Much attention is also paid to higher risk of anesthesiological complications (difficulties in intubation, necessity of high dosages of anesthetic medication administration, problems with subarachnoideal and epidural anesthesia). An increased risk of endometritis in puerperium, thrombosis, vulvitis and infections of urinary tract have been observed in obese women. Maternal obesity is correlated with decreased percentage of breast-feeding women. Particular medical care and long-term observation should be applied in case of children of obese women, as the former are at a high risk of obesity in puberty and in adult life. Nowadays, it is suggested that maternal excessive body mass should be regulated before conception and the course of pregnancy in obese women should be closely monitored. Above-mentioned arguments seem to be reason enough for future investigations of etiology and treatment of obesity in pregnancy.