الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Riley et al (2018) in their study about “Obesity in Pregnancy: Risks and
Management” in America stated that the worldwide prevalence of obesity has increased over the past few decades. They added that economic, technological, and lifestyle changes have created an abundance of healthy, high-calorie food coupled with decreased required physical activity. Additionally, Sedky et al (2021) in their study about “Combating the High Prevalence of Obesity among Egyptian Households: A Pilot Study: Port-Said Households” stated that obesity is a major public health issue in Egypt and its repercussions are not only limited to the health dimension, but also extend to affecting the productive capacity of the citizens. They added that according to the “100 million Seha” initiative, 39.8% of Egyptian adults suffer from obesity Also, Strauss (2021) in his study about “Obesity in pregnant women: maternal,fetal, and transgenerational consequences” in the UK and Europe, showed that women are an integral part of this overflowing wave of obesity. They revealed that maternal obesity can result in negative outcomes for both women and fetuses. Also, they added that the maternal risks during pregnancy include gestational diabetes and preeclampsia and the fetus is at risk for stillbirth and congenital anomalies Meanwhile, Poston et al in their study about “Obesity in Pregnancy:Implications for the Mother and Lifelong health of the Child. A Consensus Statement”in Europe observed that pregnancy problems are more common when the mother is overweight or obese. Also, they added that labor is complicated by uterine dysfunction,which affects the quality of labor.Likewise, Kyozuka et al (2022) in their study about “Gestational Weight Gainas a Risk Factor for Dystocia during First Delivery: a Multicenter Retrospective Cohort Study in Japan” stated that a pre-pregnancy BMI > 30.0 kg/m2 was an independent risk factor for dystocia (aabnormality in the progression of labor). Also, they added that apre-pregnancy BMI > 30.0 kg/m2 was an independent risk factor for dystocia, and it is one of the most common obstetric complications among nulliparous women for which medical intervention is justified because dystocia is associated with operative vaginal delivery and cesarean section (Additionally, Azaïs et al (2017) conducted their study in France about “the Effects of Adipokines and Obesity on Uterine Contractility” showed that obesity is
associated with alterations in the quality of labor, such as delayed spontaneous labor prolonged labor, increased oxytocin requirements, and an increased incidence of cesarean sections The purpose of the present study was to assess the effect of obesity on progress of labor. A descriptive research design was utilized in carrying out the current study
was conducted at labor units in three different settings in Menoufia governorate, namely the University Hospital, Shebin El-Kom Teaching Hospital, and Menouf Hospital.The sample type in this study was a purposive sample of 370 laboring women,divided into two groups: the obese group and the normal weight women group. Each group had 185 participants.Throughout the course of the present study, data was collected using inst uments that were developed by the researcher arevised by qualified experts, then tested forvalidity and reliability. Two instruments were developed and used for data collection.Instrument I: Structured interview questionnaire This questionnaire was developed by the researcher based on pertinent literature and the guidance of the supervisors and was subjected to validity and reliability measures and a pilot study. It consisted of socio-demographic and medic characteristics of women (age, education, occupation, menstrual, obstetric, medical-
surgical history, etc.) and other data such as weight and height to calculate BMI.Instrument II: Partogram to assess the progress of labor
Most partograms contain fetal and maternal records in addition to cervical dilation (WHO, 2007; Mitchell, 2010).Approaches to ensure ethics regarding confidentiality and informed consent were considered in the study. All laboring women were informed that the information they provided during the study would be kept confidential and used only for statistical purposes, and after finishing the study, the findings would be presented as a group of data with no personal participant information remaining.Regarding the findings of the current study, there was a lower mean duration of the latent and active phases, first stage, second stage, and total duration of labor in the normal-weight group than in the obese group. There were statistically significant differences among the obese and normal-weight women regarding the occurrence of complications during childbirth. where complications were higher in the obese group
than in the normal weight group. Nearly half of the obese group had CS delivery,compared to only one-third in the normal weight group. Althere was a highly significant negative correlation between the body mass index and the cervical dilatation rate, while there was a positive correlation between the body mass index and the oxytocin dose. In addition, the present study also concluded that the results of this study showed that obesity was associated with slow progress of labor and prolonged duration of the first and second stages of labor. Based on the present study findings, the research questions were all answered, and the following recommendations are suggested:encourage the maternity nurses to advise pregnant women to avoid weight gain rather than the medically recommended (according to BMI) to avoid complications in
pregnancy and labor; distribute colorful brochures regarding effect of obesity on progress of labor and the health education to reduce its effects to both nurses and women to increase their awareness. Also, encourage the maternity nurses to use the