Super-obese pregnancy - understanding the difference from a normal pregnancy and using early multidisciplinary intervention can lead to good outcomes: a case report

Super-obesity (defined as a body mass index > 50 kg /m2) is quite rare in Japan, and associated with various perinatal complications. Here we report a case of a 30-year-old nulliparous woman with a body mass index of 55.2. Obstetricians, anesthesiologists, physicians, and dietitians provided information and counseling from the early stage of pregnancy, given the potential difficulties during pregnancy and labor. She gained only 2 kg during the pregnancy, and the pregnancy course was uneventful except for the emergence of gestational diabetes and initiation of insulin therapy. To address the difficulties associated with super-obesity, three fetal anatomical scans were performed, a bariatric ward bed and operating table were prepared, and an epidural catheter was inserted early in labor. At 40 weeks of gestation, a baby was delivered vaginally after spontaneous labor onset. Although uterine contractions were difficult to detect, the measures taken made it possible to manage labor without any notable complications.