Pregnancy following gastric bypass surgery for morbid obesity

Abstract

Severe iron deficiency anemia resulting from malabsorption can complicate pregnancy following gastric bypass surgery for morbid obesity. For women of childbearing age, this potential adverse effect must be considered.

Reproductive Considerations and Pregnancy after Bariatric Surgery: Current Evidence and Recommendations

“…Case reports of pregnancy after bariatric surgery demonstrated concerning complications related to poor maternal nutritional status, including anemia, neural tube defects, and intrauterine growth retardation (IUGR) [24][25][26]. In addition, a case of gastrointestinal bleeding after vertical banded gastroplasty and reports of fatal bowel obstruction secondary to internal intestinal herniation after Roux-en-Y gastric bypass caused further alarm among both bariatric surgeons and obstetricians alike [27,28].…”

A 40-Year-Old Woman With Diabetes Contemplating Pregnancy After Gastric Bypass Surgery

“…However, gastric bypass carries risks 22 including nutritional deficiencies because of decreased nutrient intake as well as decreased fat absorption. With a Roux-en-Y bypass, iron-deficiency anemia is particularly prone to occur because of the lack of acid in the gastric pouch, which slows the absorption of iron, 23,24 as Mrs T experienced. Intestinal herniation and obstruction have occurred during pregnancy after gastric bypass, 25,26 including 1 case of maternal and fetal death.…”

The surgical management of obesity in young women: consideration of the mother’s and baby’s health before, during, and after pregnancy

“…One case report documents a pregnancy after gastric bypass for morbid obesity that was complicated by chronic iron deficiency refractory to oral supplementation because of malabsorption. However, transfusion of 4 U at 30 weeks improved hemoglobin and hematocrit, and the pregnancy resulted in a healthy term baby [73].…”