Intrapartum Management of the Obese Gravida

Obese women are at increased risk for multiple labor abnormalities, including postdates pregnancy, failed induction of labor, prolonged labor, cesarean delivery, and postpartum hemorrhage (PPH). Prolonged labor among obese women is confined to the first stage of labor. In the setting of reassuring fetal and maternal status, increased time to progress in the first stage of labor should be allowed. Uterine atony occurs more frequently in obese women and vigilance in the prevention of PPH is critical. There is a lack of high-quality data to guide the management of induction, labor, and PPH prevention among obese women.