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The Health Roundtable
Pregnancy Weight Matters
Presenter: Glyn Teale
Hospital Code Name: Wombat
Innovation Poster SessionHRT1104b – MaternityMarch 10-11 2011
The Health Roundtable
KEY PROBLEM
63% of our pregnant women have a BMI over 25 >30% > BMI 30
Lack of standardisation of care for high risk group
Stopped routine weighing of antenatal women
Resistance to re-introduction of routine weighing
Clinical incidents Late diagnosis of diabetes, failed epidurals, severe
missed IUGR
The Health Roundtable
AIM OF THIS INNOVATION
Establishing weight as an important issue in
antenatal care
Risk management
Reduced incidents
Improved detection of diabetes
Improved detection of growth restriction
OH&S
The Health Roundtable
Change management strategy…
Commence working group
Develop plans
Develop guideline Develop handoutImplement training
to staff
Implement program
Please ask your midwife or doctor for information about the importance to your baby Please ask your midwife or doctor for information about the importance to your baby of appropriate weight gain throughout your pregnancy and beyondof appropriate weight gain throughout your pregnancy and beyond
A new program for pregnant women delivering at A new program for pregnant women delivering at Goulburn Valley Health Goulburn Valley Health
from from 1st February 20101st February 2010
BMI >35BMI 18.5 - 35BMI < 18.5
26 weeks – reassess weight – advise if outside target weight change
36 - 38 weeks – reassess weight – advise if outside target weight changeAdvise about weight management after pregnancy
35 weeks: US/S for growth
36 weeks: Specialist review
28 weeks: repeat OGTT
Refer to dietitian
Arrange early OGTT
Refer to dietitian
Booking - Calculate BMI / establish target weight gain rangeIn
creased su
rveillance
32 weeks – primip/high risk multip – PAC
Post-natal - Advise about weight management after pregnancy
The Health Roundtable
AIM OF THIS INNOVATION – Achieved?
Establishing weight as an important issue in
antenatal care
Risk management
Reduced incidents
Improved detection of diabetes
8 ‘type II’ diabetics diagnosed < 20 weeks
Improved detection of growth restriction
OH&S
The Health Roundtable
LESSONS LEARNT
Multidisciplinary team
Present the risks before suggesting change Obesity risks > Smoking risk ----- brings home the
message
Time involved in counselling can be an issue
