Reduction of Morbidity and Mortality in Gynaecology associated with obesity

NHS Borders clinical guidelines
NHS Borders

Audience

Gynaecology Team

Obesity (defined as a BMI >30) is recognised to be associated with increased intra and post operative complications (TOG), particularly relating to open surgery. Wound placement, anaesthesia and laprascopic procedures can all be more challenging with increasing BMI. In order to reduce morbidity and mortality associated with surgical procedures relating to benign gynaecology, the Obstetrics and Gynaecology department of Borders General Hospital propose the following guidance.

  1. Careful consideration should be made as to whether surgical management is clinically indicated. Alternative treatments should be recommended such as
    1. weight loss and physiotherapy for stress urinary incontinence or
    2. intra-uterine system (IUS) for management of heavy menstrual bleeding.

 

  1. Careful consideration of route of surgery should be made for individuals with BMI>30 with preference to laparoscopic and vaginal routes.

 

  1. Women with BMI>35 and those with comorbidities will not be offered benign gynaecological surgery unless
    1. Clinically unwell (ie. acute ovarian torsion)
    2. Suspicion of malignancy
    3. Alternative measures have failed, and individual case has been discussed at multi-disciplinary meeting

 

Nausea and Vomiting of Pregnancy/Hyperemesis Gravidarum Management

Management in the community/outpatient

Management as a day case in the Antenatal Ward

Editorial Information

Last reviewed: 05/01/2026

Next review date: 05/01/2029

Author(s): Dr Kate Darlow, Dr Ibti Abokharais.

Version: 1.0.0

Approved By: Consultant team for Obs and Gynae and CMT