Pregnancy after bariatric surgery: a current view of maternal, obstetrical and perinatal challenges
Pregnancy after bariatric surgery: a current view of maternal, obstetrical and perinatal challenges
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DOI：
10.1007/s00404-011-2187-0
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发表时间：
2012-03-01
影响因子：
2.6
通讯作者：
Turato, Egberto Ribeiro
中科院分区：
文献类型：
--
作者：
Magdaleno, Ronis, Jr.;Pereira, Belmiro Goncalves;Turato, Egberto Ribeiro
随着育龄妇女接受减肥手术数量的增加，医生必须担心减肥手术后妊娠的安全性。本综述的目的是总结 BS 后妊娠对孕产妇、产科和围产期影响的文献报道。2005 年至 2011 年 2 月的 PUBMED 搜索中使用“怀孕和减肥手术或胃旁路手术或胃束带术”的关键词，找到了英语、西班牙语和葡萄牙语文章。研究表明，减肥手术后孕妇的生育能力得到改善，妊娠糖尿病、妊娠高血压和先兆子痫、巨大儿的风险降低。宫内生长受限和小于胎龄的发生率增加。关于剖腹产的风险和最佳手术到受孕间隔尚无结论。铁、维生素 A、维生素 B12、维生素 K、叶酸和钙的缺乏会导致母婴并发症。与肥胖人群相比，BS 后分娩的女性的妊娠结局更好、更安全，与普通人群相当。在怀孕前、怀孕期间和怀孕后进行密切监督，并根据患者的个人需求进行减肥手术和营养补充，可以预防营养相关的并发症，改善母婴健康。
With the increase in the number of bariatric surgeries being performed in women of childbearing age, physicians must have concerns regarding the safety of pregnancy after bariatric surgery. The aim of this review is to summarize the literature reporting on maternal, obstetrical and perinatal implications of pregnancy following BS.English, Spanish and Portuguese-language articles were identified in a PUBMED search from 2005 to February 2011 using the keywords for pregnancy and bariatric surgery or gastric bypass or gastric banding.The studies show improved fertility and a reduced risk of gestational diabetes, pregnancy-induced hypertension and pre-eclampsia, macrosomia in pregnant women after bariatric surgery. The incidence of intrauterine growth restriction and small for gestational age are increased. No conclusions can be drawn concerning the risk for cesarean delivery and the best surgery-to-conception interval. Deficiencies in iron, vitamin A, vitamin B12, vitamin K, folate and calcium can result in maternal and fetal complications.Pregnancy outcome of women who delivered after BS, as compared to obese populations, is better and safer and comparable to the general population. Close supervision before, during and after pregnancy following bariatric surgery and nutrient supplementation adapted to the patient's individual requirements can prevent nutrition-related complications and improve maternal and fetal health.