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February 19, 1938

"NORMAL EXPECTANCY" IN THE EXTREMELY OBESE PREGNANT WOMAN

JAMA. 1938;110(8):554-559. doi:10.1001/jama.1938.02790080012004
Abstract

Obesity is a well recognized pathologic entity. Pregnancy, although looked on as a normal physiologic function, must be carefully guided through the various pitfalls of an uncertain antepartum course. Individually these conditions are treated according to well established principles. In combination they form a dangerous alliance which calls for constant vigilance. To borrow a famous colloquial expression, "Let's look at the record."

This report is based on a study of 200 pregnant women, all of whom weighed more than 200 pounds, or 90 Kg. (table 1). During the period of this investigation, from April 1932 to October 1936, there were 6,025 deliveries in the Coney Island Hospital. This gives a ratio of one obese patient to every thirty deliveries.

ANTEPARTUM OBSERVATIONS  That we were faced with a definite problem in antepartum care soon became a certainty. As pregnancy progressed, more and more complications were encountered. Edema, albuminuria, hypertension, headache and

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