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

Beard, Jessica H.; Bell, Robert L.; Duffy, Andrew

doi:10.1007/s11695-007-9389-3

Cited by 95 publications

(80 citation statements)

References 35 publications

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“…35 until after the period of maximal weight loss (12-18 months). 8 Extra vigilance in preconception, antenatal and obstetric care is required.…”

Section: Nutritional Deficienciesmentioning

confidence: 99%

“…1 Diet, exercise and drug treatments for severe obesity have been disappointing. [1][2][3][5][6][7][8][9][10][11][12] At the present time, bariatric surgery is the only treatment that reliably produces substantial and sustainable weight loss. [1][2][3][4][5][6][7]9,13 It is indicated in people with BMI >40 kg/m 2 or with BMI >35 kg/m 2 in the presence of significant comorbidity.…”

Section: Introductionmentioning

confidence: 99%

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Overview of bariatric surgery for the physician

Hng

Ang

2012

Clinical Medicine

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-The worldwide pandemic of obesity carries alarming health and socioeconomic implications. Bariatric surgery is currently the only effective treatment for severe obesity. It is safe, with mortality comparable to that of cholecystectomy, and effective in producing substantial and sustainable weight loss, along with high rates of resolution of associated comorbidities, including type 2 diabetes. For this reason, indications for bariatric surgery are being widened. In addition to volume restriction and malabsorption, bariatric surgery brings about neurohormonal changes that affect satiety and glucose homeostasis. Increased understanding of these mechanisms will help realise therapeutic benefits by pharmacological means. Bariatric surgery improves long-term mortality but can cause long-term nutritional deficiencies. The safety of pregnancy after bariatric surgery is still being elucidated.

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“…35 until after the period of maximal weight loss (12-18 months). 8 Extra vigilance in preconception, antenatal and obstetric care is required.…”

Section: Nutritional Deficienciesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Overview of bariatric surgery for the physician

Hng

Ang

2012

Clinical Medicine

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“…Recent studies on pregnant women after bariatric surgery with micronutrient deficiencies have proved no adverse perinatal outcomes. (36)(37)(38) In respect to obstetric risks, the remarkable fetomaternal benefits after bariatric surgery is the reduction of GDM and hypertension. ( 39) In our study the prevalence of preeclampsia, and GDM was 9%, 2.2% respectively.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy after Two Different Modalities of Bariatric Surgery. What to Expect?

Youssry¹

2018

jmscr

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“…This follow-up included anthropometric assessment (weight, height and BMI). The goal of the nutritional counseling was to achieve 15 to 25 kcal/kg/day 13 to reach gestational weight gain of 7-11 kg, as recommended for overweight pregnant women (BMI from 26.1 to 29.0 kg/m 2 ) by the Institute of Medicine. 14 The patients were instructed to eat small meals, cutting all foods into small pieces, especially meats, fruits, and vegetables.…”

Section: Methodsmentioning

confidence: 99%

Avaliação da vitalidade fetal e resultados perinatais em gestações após gastroplastia com derivação em Y de Roux

Nomura¹,

Dias²,

Igai³

et al. 2010

Rev. Assoc. Med. Bras.

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Nomura rmY et al. 670Rev Assoc Med Bras 2010; 56(6): Incidence and prevalence of morbid obesity have increased and bariatric surgery has emerged as a treatment option for this disease. Amongst patients who undergo bariatric surgery, many are women of childbearing age and, after surgery, there is significant improvement in fertility, with normal hormone levels and menstrual cycles, which promotes the occurrence of pregnancy. 1 The benefits of bariatric surgery consist of reduction in body weight and mitigation of risks related to associated comorbidities. However, there are major drawbacks caused by the nutritional deficits that are triggered by malabsorption of nutrients induced by the gastric bypass.Pregnancy in obese women is associated with higher rates of maternal and perinatal complications as compared to pregnancies in women with normal body mass index (BMI). There is increased incidence of diabetes, hypertension, cesarean delivery, fetal macrosomia, and anesthetic complications. 2-5 Nevertheless, studies involving pregnant women who underwent previous bariatric surgery have not demonstrated a significant impact on perinatal outcomes. [6][7][8][9] On the other hand, regarding the effects on the maternal compartment in patients with morbid obesity, most studies have reported encouraging results after bariatric surgery. Some Results. Thirty pregnancies after Roux-en-Y gastric bypass were identified and 24 of them had fetal well-being assessed. All patients had normal results on cardiotocography, fetal biophysical profile, and umbilical artery Doppler velocimetry. There was one case of oligohydramnios. The main complication was maternal anemia (Hb < 11.0 g/dL, 86.7%). Twenty-one patients had cesarean section (70%). Delivery-related complications included one case of adherence, one of hematoma and uterine wall infection, and one of postpartum hysterectomy because of uterine fibroids and atony. The rate of small for gestational age infants was 23.3%. Conclusion.There was no impairment of fetal well-being in pregnancies after Roux-en-Y gastric bypass. The main maternal complication was anemia and these patients need specific nutritional counseling including broad assessment of micronutrient deficiencies since the early stages of pregnancy.

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

Cited by 95 publications

References 35 publications

Overview of bariatric surgery for the physician

Overview of bariatric surgery for the physician

Pregnancy after Two Different Modalities of Bariatric Surgery. What to Expect?

Avaliação da vitalidade fetal e resultados perinatais em gestações após gastroplastia com derivação em Y de Roux

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