Medications for Pregnant Women With Obesity: Special Considerations
Pregnant women with obesity are at increased risk of a multitude of complications of pregnancy and adverse perinatal outcomes. The risk of some of these complications, such as neural tube defects or preeclampsia, may be mitigated by some medications. Other complications, such as diabetes, venous thromboembolism, and infections, require treatment with medications. Given the changes in pharmacokinetics and pharmacodynamics during pregnancy, which is further enhanced by obesity, the optimal medication and its dose is often researched. This chapter further explores the different complications and common medications that women ...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Diabesity and Perinatal Mental Health: Evidence-based Recommendations for Screening and Intervention
Perinatal mental illness, obesity, and diabetes mellitus are common complications of the perinatal period that are becoming ever more prevalent and frequently co-occur. This review seeks to examine the prevalence of comorbid obesity/diabetes (termed “diabesity”) and mental illness in the perinatal period and current understandings of the psychosocial and pathophysiological relationships between these diseases. We will present current guidelines for screening and make recommendations for adaptations of mental health treatment in patients with this comorbidity. Finally, we present future directions for research and clini...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Sleep Duration, Sleep Timing, and Sleep Disordered Breathing—Associations With Obesity and Gestational Diabetes in Pregnancy
This article will review the epidemiology of sleep duration, sleep timing, and sleep disordered breathing in pregnancy with a focus on how the prevalence of these sleep conditions relate to body mass index. In addition, it will summarize the literature suggesting a link between these sleep disturbances and an increased risk for gestational diabetes. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Diabesity and Pregnancy: How Do We Get Our Patients Moving?
Obesity and diabetes are 2 commonly encountered complications in pregnancy that adversely affect pregnancy outcomes, maternal health, and the health of the offspring, both short-term and long-term. It is well established that physical activity provides numerous health benefits, both during and outside of pregnancy. By participating in physical activity, many of the negative consequences of both obesity and diabetes may be mitigated. Physical activity guidelines recommend that all adults, including pregnant women, perform at least 150 minutes of moderate-intensity exercise weekly in order to obtain health benefits. More phy...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Group Prenatal Care as a Strategy to Address Diabesity
Group prenatal care is a health care delivery model that utilizes shared medical appointments to place greater focus on patient education, mutual support, and increased time with the clinician to promote a healthy pregnancy. Several studies suggest that medically low-risk women participating in group prenatal care have improved pregnancy outcomes, but the same tenants can likely be used to help women with diabetes and obesity achieve healthy outcomes during pregnancy and throughout their life course. This chapter will review the background, care model, and evidence regarding group medical visits for pregnant women with dia...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

A Pragmatic Approach to the Treatment of Women With Type 2 Diabetes in Pregnancy
Type 2 diabetes mellitus (DM) is a growing problem among reproductive-aged women. Contemporary trends in obesity and delayed child-bearing are expected to result in an increasing number of pregnancies affected by type 2 DM. Women with known type 2 DM can greatly benefit from preconception care as improved periconception glycemic control and weight loss can decrease the neonatal and maternal risks associated with type 2 DM and pregnancy. Antenatal mainstays of management include frequent blood glucose monitoring, insulin therapy, optimization of coexisting medical conditions, and fetal surveillance. Careful attention to pos...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Ultrasound for the Pregnant Person With Diabesity
Diabetes and obesity increase the risk of congenital anomalies, but the putative mechanisms of this increased risk are not fully elucidated. In this chapter, we delve into sonographic characteristics associated with diabetes and obesity, including fetal structural anomalies, functional cardiac alterations, and growth abnormalities. We will also discuss the technical challenges of imaging in the patient with diabesity and propose methodologies for optimizing imaging. Lastly, we will address the prevention of workplace-associated musculoskeletal disorders injury for sonographers. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Screening for Aneuploidy in the Patient With Diabesity: Pearls and Pitfalls
The American College of Obstetrics & Gynecology (ACOG) recommends offering aneuploidy screening to all pregnant women. Obesity and diabetes are not associated with an increased risk of aneuploidy; however, they can complicate and compromise testing options. As the prevalence of obesity and diabetes, or “diabesity” increases, counseling women regarding potential limitations in testing performance of aneuploidy screening is of paramount importance. This chapter reviews options for aneuploidy screening for women with diabesity including sonography/nuchal translucency, serum analyte screening, and cell-free DNA. Potential ...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Foreword: Diabesity: Type 2 Diabetes and Obesity
No abstract available (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Clinical Obstetrics and Gynecology Source Type: research

Contributors: Diabesity: Type 2 Diabetes and Obesity
No abstract available (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Contributors: Diabesity: Type 2 Diabetes and Obesity Source Type: research

Animal Models in Polycystic Ovarian Syndrome
The pathogenesis of polycystic ovarian syndrome (PCOS) in women is poorly understood. With its varied endocrine and metabolic effects, it is unlikely a single genetic mutation or biological insult is the cause of the disease. Animals have been the proposed model for further studying the pathogenesis of PCOS and many modalities can be used to induce PCOS-like phenotypes in animals, most often with rodents. While there is not yet an animal model that perfectly recapitulates the classic PCOS phenotype in human women, many models allow for a better understanding of the complex disease process as well as possible treatments. (S...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Menstrual Dysfunction in PCOS
Menstrual irregularities due to anovulation or severe oligoovulation are a key feature of polycystic ovary syndrome for many women. First-line intervention should entail dietary and lifestyle modifications for overweight or obese polycystic ovary syndrome women. For women not seeking fertility, combination low-dose hormonal contraception are the most effective and first-line choice for regulating menstrual cycles. This option, as well as progestin-only options, have the important added benefit of reducing risks of endometrial hyperplasia and cancer. Metformin is an appropriate medical option to improve ovulation rates for ...
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Polycystic Ovary Syndrome and Medical Conditions
Polycystic ovary syndrome is a common endocrinopathy that has been associated with many medical conditions across nearly every specialty. This chapter reviews the current understanding of polycystic ovary syndrome and associated medical conditions. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Polycystic Ovary Syndrome: Menopause and Malignancy
Polycystic ovary syndrome (PCOS) has been extensively studied in reproductive-aged women. However, accumulating research shows that PCOS can have lifelong effects on multiple aspects of women’s health. PCOS can affect the onset and course of menopause and cardiovascular health in perimenopausal and postmenopausal patients. Moreover, PCOS may increase a woman’s risk for both gynecologic and nongynecologic malignancies. When treating older PCOS patients, physicians should be cognizant of the syndrome’s long-term effects and consider the unique needs of these women. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research

Cosmetic Endocrinology
Cosmetic endocrinology treats endocrine pathophysiologies to improve cosmetically bothersome physical exam findings for the patient. Here we review the general cosmetic changes in PCOS with an emphasis on targeted cosmetic medical therapies. (Source: Clinical Obstetrics and Gynecology)
Source: Clinical Obstetrics and Gynecology - January 24, 2021 Category: OBGYN Tags: Polycystic Ovary Disease Source Type: research