Imaging and obesity: a perspective during pregnancy.
OBJECTIVE
Obesity is a rapidly growing global pandemic that has surpassed all other risk factors in obstetric care, converting 40% of pregnant women into a high-risk category, with the attendant increased burden on our health care systems. This article will review the role of the imaging specialist in understanding the determinants of poor pregnancy outcome in the mother and her baby. We will also review how obesity affects the quality of patient care in terms of the limitation in completion of fetal anatomic surveys, ergonomic risks to the imaging specialist, and techniques that may improve imaging quality and ensure patient safety. We urgently need refinement in our ability to detect those fetuses at greatest risk for stillbirth and growth restriction, macrosomia, and congenital anomalies, and to understand the potentially multigenerational impact of maternal obesity on the incidence of obesity and the metabolic syndrome for the future. Utilization of emerging technologies such as laser Doppler, evolving MRI technology, and expanded roles for ultrasound such as ultrasound guidance for placement of labor anesthesia will become increasingly important.


CONCLUSIONS
The far-reaching implications of obesity on the mother and her children will continue have a progressive impact on our health care systems and resources.
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Mount Sinai Hospital, Toronto, ON, Canada.
Cynthia
C
Maxwell
Phyllis
P
Glanc
D000328:Adult; D050110:Bariatric Surgery; D002585:Cesarean Section / Q000379:methods; D015897:Comorbidity; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D006801:Humans; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000601:surgery; D009765:Obesity / Q000453:epidemiology* / Q000601:surgery; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000453:epidemiology*; D011256:Pregnancy Outcome; D018570:Risk Assessment; D016216:Ultrasonography, Prenatal / Q000379:methods