Obese or morbidly obese patients who struggle to lose weight on their own are often recommended weight loss surgery, also known as bariatric surgery. Losing weight is not an easy task for many people, and when other types of medically supervised weight loss programs are not effective, patient. Losing weight alone is not an easy task and numerous patients are recommended one of the different types of bariatric surgery conducted in the country, which includes gastric bypass, sleeve gastrectomy, adjustable gastric band (gastric banding), and biliopancreatic diversion with duodenal switch.
Roux-en-Y Gastric Bypass, also known as “gastric bypass,” is the most common type of bariatric surgery and is performed in two phases. First, the surgeons staple part of the stomach, creating a small pouch, and then they connect the recently-created pouch to the small intestine. It works by both reducing the size of the stomach and rearranging the digestive system, which causes alterations in gut hormones, improving satiety, restricting the amount of food consumed and the absorption of calories. Despite being considered safe and effective, before deciding for a bariatric surgery patients need to consider its impact on all aspects of their life, including pregnancy.
Benefits of a Gastric Bypass in Future Pregnancies
While the patients submitted to gastric bypass can see improvements in weight loss and overall health, they may also experience benefits regarding pregnancy. According to the study “Pregnancy after Bariatric Surgery: A Review,” there are improvements in fertility and reductions in risks, including gestational diabetes, hypertension and preeclampsia for the mother, as well as fetal macrosomia (overweight at birth) for the baby. There are, however, no alterations on the percentage of miscarriages before or after the surgery.
“There is increasing evidence to suggest that weight loss after bariatric surgery may improve maternal and perinatal outcomes by reducing obesity-associated obstetric risk factors. Although there is a paucity of robust randomized control trials in this area, a number of recent case-control and cohort studies demonstrate that women who have had preconceptual bariatric surgical procedures may have lower rates of obesity-related pregnancy complications such as gestational diabetes and hypertensive disorders than either historical controls or women who had pregnancies before their bariatric procedures,” explain the authors.
Potential Problems of Getting Pregnant After a Gastric Bypass
Despite the improvements in fertility, the mother’s and the baby’s health, a gastric bypass is an aggressive surgery that alters the digestive system. Therefore, it can have a potentially harmful impact on patients’ pregnancies, and patients are recommended to seek guidance from their healthcare providers before trying to conceive. It is common for physicians to ask patients to wait a least 12 to 18 months after the surgery, which will enable weight stabilization. Due to fast or persistent weight loss, there are cases of nutritional deficiencies for both the mother and the infant. In addition, there is also a higher risk of birth defects, while the increase in intra-abdominal pressure, displacement of organs by a gravid uterus, and predisposition to vomiting during the pregnancy also has risks for women who were submitted to gastric bypass.
Although the overall results are encouraging, the authors emphasize that “there remains uncertainty about the increased rates of small-for-gestational age and intrauterine growth restricted infants, as well as premature rupture of membranes in this group,” referring to women to get pregnant after a bariatric surgery and their respective children. “A number of case reports highlight that pregnancy following bariatric surgery is not without complications and it must be managed as high risk by the multidisciplinary team,” they added.
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