Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Mount Sinai Hospital, Toronto, ON, Canada.
AJR Am J Roentgenol. 2011 Feb;196(2):311-9. doi: 10.2214/AJR.10.5849.
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.
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.
肥胖是一种迅速蔓延的全球流行疾病,在产科护理中,它已经超越了所有其他风险因素,使 40%的孕妇成为高危人群,这给我们的医疗保健系统带来了更大的负担。本文将综述影像学专家在了解母亲和婴儿不良妊娠结局的决定因素方面的作用。我们还将回顾肥胖如何影响患者护理的质量,包括完成胎儿解剖检查的限制、对影像学专家的人体工程学风险,以及可能改善成像质量和确保患者安全的技术。我们迫切需要提高检测那些最有可能发生死产和生长受限、巨大儿和先天性畸形的胎儿的能力,并了解母亲肥胖对肥胖和代谢综合征发病率的潜在代际影响,为未来做好准备。新兴技术的应用,如激光多普勒、不断发展的磁共振成像技术,以及超声的扩展应用,如用于分娩麻醉定位的超声引导,将变得越来越重要。
肥胖对母亲及其子女的深远影响将继续对我们的医疗保健系统和资源产生持续的影响。