Comment & Controversy

Estimating fetal weight is difficult in obese women

“FOR THE OBESE GRAVIDA, TRY STRONG COUNSELING AND CLOSE FOLLOW-UP”
“DELIVERY AND POSTPARTUM CONCERNS IN THE OBESE GRAVIDA” JULIE PHILLIPS, MD, AND JANICE HENDERSON, MD (FEBRUARY 2009)

I enjoyed the articles on obesity in pregnancy and would like to add one point. Ultrasonographic imaging in the obese gravida is often poor. I suggest that the anatomic survey, usually recommended for 18 to 20 weeks of gestation, be postponed to 22 to 24 weeks in this population. True, you may miss the opportunity to assess the nuchal fold, but that is not so important if you also perform first-trimester genetic screening.