title: Obesity in pregnancy: altered onset and progression of labour.
abstract: BACKGROUND
  the incidence of obesity increases in all developed countries to frightful percentages, also in women of reproductive age. Maternal obesity is associated with important obstetrical complications; and this group also exhibits a higher incidence of prolonged pregnancies and labours.
  
  
  OBJECTIVE
  to review the literature on the pathophysiology of onset and progression of labour in obese woman and translate this knowledge into practical recommendations for clinical management.
  
  
  METHODS
  a literature review, in particular a critical summary of research, in order to determine associations, gaps or inconsistencies in this specific but limited body of research.
  
  
  RESULTS
  the combination of a higher incidence of post-term childbirths and increased inadequate contraction pattern during the first stage of labour suggests an influence of obesity on myometrial activity. A pathophysiologic pathway for altered onset and progression of labour in obese pregnant women is proposed.
  
  
  CONCLUSIONS
  analysis of the literature shows that obesity is associated with an increased duration of pregnancy and prolonged duration of first stage of labour.
  
  
  CONCLUSIONS
  an adapted clinical approach is suggested in these patients.
authors: Limburg Catholic University College, PHL University College, Department of PHL-Healthcare Research, Oude Luikerbaan, 79, 3500 Hasselt, Belgium.
authors: Annick
authors: A
authors: Bogaerts
authors: Ingrid
authors: I
authors: Witters
authors: Bea R H
authors: BR
authors: Van den Bergh
authors: Goele
authors: G
authors: Jans
authors: Roland
authors: R
authors: Devlieger
mesh_terms: D005260:Female; D006801:Humans; D007747:Labor Stage, First / Q000502:physiology*; D007743:Labor, Obstetric; D009765:Obesity / Q000150:complications*; D010346:Patient Care Management / Q000379:methods; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology / Q000628:therapy
keywords: Obesity; Onset of labour; Pregnancy; Progression of labour