Pregnancy Following Gastric Bypass for Morbid Obesity

Abstract

Since the patients had an operation that restricts their food intake, some basic precautions should be taken when they become pregnant. With this in mind, our patients have done well with their pregnancies. The post-surgical group had fewer pregnancy-related complications than did an internally controlled group that were morbidly obese during their previous pregnancies.

Maternal obesity: do patients understand the risks?

“…Because of the multitude of co-morbidities associated with obesity in pregnancy, especially childhood obesity, obesity prevention should be a priority. Although studies have not addressed how weight loss before pregnancy affects pregnancy outcomes, except in the setting of bariatric surgery, [26][27][28] the adverse outcomes associated with maternal obesity underline the urgency of preconception counseling with the goal to optimize weight and nutrition before pregnancy.…”

Gestação após gastroplastia para tratamento de obesidade mórbida: série de casos e revisão da literatura

“…Em nossa pequena série de casos, não foram evidenciadas complicações maternas nem fetais dignas de nota, corroborando achados de outros autores 5,6,11 . Dados da literatura apontam que, comparando-se gestações de pacientes obesas mórbi-das antes da gastroplastia e após a perda de peso induzida pela cirurgia, encontra-se redução significativa na necessidade de cesárea, incidência de macrossomia e diabete gestacional 5,12 .…”

“…Uma vez que essas pacientes podem evoluir com deficiências de alguns compostos como ferro, vitamina B 12 , folato e cálcio, isso poderia resultar em aumento do risco para complicações maternas (anemia) e fetais (defeito no tubo neural, restrição no crescimento intra-uterino), recomendando-se o adequado manejo nutricional no pós-operatório, especialmente quando se planeja futura gestação, para assegurar concentrações séricas adequadas desses nutrientes antes da gestação.…”

Tratamento cirúrgico da obesidade mórbida implicações gestacionais

“…Although few studies have specifically evaluated this issue, finding no significant changes between early and late pregnancies, strict contraception is generally recommended for at least one year after the surgery. 17 With respect to maternal and fetal parameters, Wax et al found no differences in patients undergoing RYGB compared with controls from the general population regarding the incidence of hypertension, premature rupture of membranes, oligohydramnios, and delivery after 41 weeks. 18 On the other hand, comparing pregnant women with obese women who underwent bariatric surgery, Wittgrove et al 17 demonstrated that the incidence of complications in the surgery group is smaller than in the population of nonoperated obese individuals.…”

“…17 With respect to maternal and fetal parameters, Wax et al found no differences in patients undergoing RYGB compared with controls from the general population regarding the incidence of hypertension, premature rupture of membranes, oligohydramnios, and delivery after 41 weeks. 18 On the other hand, comparing pregnant women with obese women who underwent bariatric surgery, Wittgrove et al 17 demonstrated that the incidence of complications in the surgery group is smaller than in the population of nonoperated obese individuals. Likewise, their series showed a lower incidence of Edi torial macrosomia, hypertension, and diabetes in operated women compared with the morbid obese population.…”