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: Obesity is a worldwide public health problem, affecting at least one-third of pregnant women. One of the main problems of obesity during pregnancy is the high rate of cesarean section. The leading cause of this higher frequency of cesarean sections in obese women compared with that in nonobese women is an altered myometrial function that leads to lower frequency and potency of contractions. In this article, we review the disruptions of myometrial myocytes in obese women during pregnancy that may explain dysfunctional labor. The myometrium of obese women exhibited lower expression of connexin43, lower function of the oxytocin receptor, and higher activity of the potassium channels. Adipokines, such as leptin, visfatin, and apelin, whose concentrations are higher in obese women, decreased myometrial contractility, perhaps by inhibiting the myometrial RhoA/ROCK pathway. The characteristically higher cholesterol levels of obese women alter myometrial myocyte cell membranes, especially the caveolae, inhibiting oxytocin receptor function and increasing the K+ channel activity. All these changes in the myometrial cells or their environment decrease myometrial contractility, perhaps at least partially explaining the higher rate cesarean of sections in obese women.

Objective To evaluate the maternal and perinatal outcomes in a cohort of pregnant women at high risk of venous thromboembolism (VTE). Methods Women at high risk of VTE were evaluated in a multidisciplinary program using a complete diagnostic workup, and specific prophylactic or therapeutic treatment. Results Women were considered at high risk of VTE in 57% (85/148) because of prior (75) or current (10) thromboembolism, and in 27% (40/148) of the cases due to adverse obstetric history. Thrombophilia was diagnosed in 57% of the cases (85/148), either in patients with previous thromboembolism (48%, 41/85) or without a history of thrombosis (70%, 44/63). The most common thrombophilia was antiphospholipid syndrome in 34% (29/85) of the cases. Under respective prophylactic or therapeutic treatment, there were no VTE during pregnancy (0%, 0/148), whereas four events occurred during the puerperium (3%, 4/148). An adverse obstetric outcome was present in 5% (7/148) of all pregnancies, with four early spontaneous abortions (3%, 4/148) and three late miscarriages (2%, 3/148). Conclusion Pregnant women at high risk of VTE can be effectively managed using a risk‐adapted treatment. Our results support prospective enrollment and a multidisciplinary assessment of VTE in high‐risk pregnant women.