Women who have bariatric surgery should be well informed in order to improve pregnancy outcomes.
Obesity increases the risk of infertility in both men and women and reduces the effectiveness of fertility treatments, according to Dr. Sarah Cheah of Sydney’s St George Hospital.
Almost 60% of female bariatric surgery patients are between the ages of 20 and 44, and they require appropriate contraception, peri-conception nutrition and supplementation, and weight management during and after pregnancy.
Recommendations for Pregnancy after Bariatric Surgery:
- Due to the risk of adverse pregnancy outcomes associated with rapid weight loss, pregnancy should be postponed for at least 12–18 months. According to ACOG guidelines, if pregnancy occurs before this recommended time frame, closer monitoring of maternal weight and nutritional status, as well as serial ultrasound monitoring of fetal growth, may be beneficial.
- Contraception should be prescribed following surgery, despite the fact that the effectiveness of the oral contraceptive pill may be reduced due to malabsorption, and contraceptive devices such as intrauterine devices should be considered first line therapy.
- Women should be closely monitored for nutritional deficiencies before, during, and after the surgery. Experts advise these women to have their diets evaluated and supplemented to avoid micronutrient deficiencies. The most common nutrient deficiencies after gastric bypass surgery are protein, iron, folate, calcium, and vitamins B12 and D. If no deficiencies are found, a complete blood count and measurements of iron, ferritin, calcium, and vitamin D levels should be considered every trimester.
- To assist in the multidisciplinary management of these complex patients, bariatric surgeons, medical practitioners, dieticians, the patient’s usual general practitioner, obstetricians, and maternity specialists should be involved.
Delivery and Labor
The management of labor and delivery should not be affected by bariatric surgery. Although women who have had bariatric surgery have a higher rate of cesarean delivery, this is not an indication of cesarean delivery. Pre-labor consultation with a bariatric surgeon should be considered if a patient has had extensive and complicated abdominal surgery as a result of weight-loss procedures.
To improve pregnancy-related outcomes, it is critical that these women are managed early in the prenatal period by a multidisciplinary team that includes bariatric surgeons, bariatric medical practitioners, bariatric dieticians, and the patient’s usual GP in addition to traditional obstetricians and maternity specialists.
The Content is not meant to be a replacement for professional medical advice, diagnosis, or treatment. If you have any questions about a medical condition, always seek the advice of your physician or another qualified health provider.