Obesity in women, a global issue, is being widely managed with bariatric surgery worldwide. According to recommended guidelines, pregnancy should be avoided for 12 to 24 months following surgery due to various risks. We assessed if surgery-to-conception time has a relation with pregnancy outcomes taking into account gestational weight gain. A cohort study between 2015 and 2019 followed-up pregnancies after various types of bariatric surgeries performed (e.g. Roux-en-Y gastric bypass, sleeve gastrectomy, gastric banding, gastric bypass with Roux-en-Y gastroenterostomy) in Tawam Hospital, Al Ain, United Arab Emirates. There were 5 surgery-to-conception groups: <6 months, 6 to 12 months, 13 to 18 months, 19 to 24 months, and >24 months. There were 3 gestational weight gain groups: inadequate, adequate, or excessive (based on the National Academy of Medicine classification). Maternal and neonatal outcomes were compared using analysis of variance and chi-square tests. There were 158 pregnancies. Booking maternal body mass index and weight were higher among mothers who conceived <6 months following surgery (P < .001). Gestational weight gain was not related to the type of bariatric surgery (P = .24), but it was far more often inadequate in mothers who conceived <12 months following surgery (P = .002). Maternal (including pregnancy-induced hypertension and gestational diabetes mellitus) and neonatal outcomes were not statistically significantly associated with surgery-to-conception duration. However, birth weight was lower when gestational weight gain was inadequate (P = .03). There is a negative relationship between shorter bariatric surgery-to-conception interval and gestational weight gain, a feature related to neonatal birth weight. Conception should be delayed to improve pregnancy outcomes following bariatric surgery.

The objective of this clinical case report is to highlight an uncommon presentation of chorioamnionitis as status epilepticus, complicated by consumptive coagulopathy and recurrent hypoglycemia. A primigravida of 18 weeks gestation, presented to the Accident and emergency department via ambulance with seizures. She did not have any handheld medical records. No history could be obtained as she is a visitor with no friends and family. She was disoriented with Glasgow coma scale of 10/15, random blood sugar of 1.8, blood pressure 88/58, pulse 130, and temperature 36.8°C. Scan showed an 18 weeks live fetus. She was having uncontrollable seizures even after her glucose was corrected. Patient was also started on magnesium sulphate and anti epileptic infusions. She was intubated and transferred to ICU. On vaginal examination smelly discharge was noticed. Patient was started on Broad spectrum antibiotics. Her WCC elevated to 23, other investigations like Liver function tests, urea & electrolytes and creatinine were normal. The next day patient aborted spontaneously and continued to be tachycardic, tachypneic and hyperthermic with labs showing a picture of consumptive coagulopathy. Urine, blood culture and CSF cultures were normal. After Inotropes, antiepileptic's, platelet transfusion, broad spectrum antibiotics, and appropriate fluid management, patient's condition improved. Placental histopathology confirmed chorioamnionitis. She required ventilator support for 13 days. She suffered with recurrent episodes of hypoglycemia even after her sepsis was resolved which was treated by dextrose infusion and steroids and resolved spontaneously. She was discharged on 44 th day of her hospital stay in stable condition.