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Pregnancy in the Bariatric Patient

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Complications in Bariatric Surgery

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Abstract

There is an increasing trend toward morbid obesity in women of childbearing age and a subsequent increase in number of weight reduction surgeries, in these individuals. Thus, pregnancy following weight loss surgery is increasingly encountered in clinical practice. A multidisciplinary team is needed to address these patients as they pose specific surgical, medical, and obstetric challenges. This chapter describes common considerations relating to pregnant bariatric surgical patients.

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References

  1. Vahratian A. Prevalence of overweight and obesity among women of childbearing age: results from the 2002 National Survey of Family Growth. Matern Child Health J. 2008;13(2):268–73.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Kakarla N, Dailey C, Marino T, Shikora S, Chelmow D. Pregnancy after gastric bypass surgery and internal hernia formation. Obstet Gynecol. 2005;105(5 Pt 2):1195–8.

    Article  PubMed  Google Scholar 

  3. Efthimiou E, Stein L, Court O, Christou N. Internal hernia after gastric bypass surgery during middle trimester pregnancy resulting in fetal loss: risk of internal hernia never ends. Surg Obes Relat Dis. 2009;5:378–80.

    Article  PubMed  Google Scholar 

  4. Moore KA, Ouyang DW, Whang EE. Maternal and fetal deaths after gastric bypass surgery for morbid obesity. New Engl J Med. 2004;351:721–2.

    Article  CAS  PubMed  Google Scholar 

  5. American College of Obstetricians and Gynecologists. ACOG practice bulletin no. 105: bariatric surgery and pregnancy. Obstet Gynecol. 2009;113(6):1405–13.

    Article  Google Scholar 

  6. Wax JR. Risks and management of obesity in pregnancy: current controversies. Curr Opin Obstet Gynecol. 2009;21(2):117–23.

    Article  PubMed  Google Scholar 

  7. Ehrmann DA. Polycystic ovary syndrome. N Engl J Med. 2005;352:1223–36.

    Article  CAS  PubMed  Google Scholar 

  8. McCartney CR, Marshall JC. Polycystic ovary syndrome. N Engl J Med. 2016;375(14):1398–9.

    PubMed  Google Scholar 

  9. Teitelman M, Grotegut CA, Williams NN, Lewis JD. The impact of bariatric surgery on menstrual patterns. Obes Surg. 2006;16:1457–63.

    Article  PubMed  Google Scholar 

  10. Deitel M, Stone E, Kassam HA, Wilk EJ, Sutherland DJ. Gynecologic-obstetric changes after loss of massive excess weight following bariatric surgery. J Am Coll Nutr. 1988;7(2):147–53.

    Article  CAS  PubMed  Google Scholar 

  11. Milone M, De Placido G, Musella M, et al. Incidence of successful pregnancy after weight loss interventions in infertile women: a systematic review and meta-analysis of the literature. Obes Surg. 2016;26(2):443–51.

    Article  PubMed  Google Scholar 

  12. Escobar-Morreale HF, Botella-Carretero JI, Alvarez-Blasco F, Sancho J, San Millán JL. The polycystic ovary syndrome associated with morbid obesity may resolve after weight loss induced by bariatric surgery. J Clin Endocrinol Metab. 2005;90(12):6364–9.

    Article  CAS  PubMed  Google Scholar 

  13. Eid GM, Cottam DR, Velcu LM, et al. Effective treatment of polycystic ovarian syndrome with Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2005;1(2):77–80.

    Article  PubMed  Google Scholar 

  14. Roehrig HR, Xanthakos SA, Sweeney J, et al. Pregnancy after gastric bypass surgery in adolescents. Obes Surg. 2007;17:873–7.

    Article  PubMed  Google Scholar 

  15. Merhi ZO. Weight loss by bariatric surgery and subsequent fertility. Gynecol Obstet Investig. 2007;64:100–2.

    Article  Google Scholar 

  16. Mody SK, et al. Contraceptive counseling for women who undergo bariatric surgery. J Women’s Health. 2011;20(12):1785–8.

    Article  Google Scholar 

  17. Sheiner E, et al. Pregnancy after bariatric surgery is not associated with adverse perinatal outcomes. Am J Obstet Gynecol. 2004;190(5):1335–40.

    Article  PubMed  Google Scholar 

  18. Aricha-Tamir et al. Downsizing pregnancy complications: a study of paired pregnancy outcomes before and after bariatric surgery. Surg Obes Relat Dis. 2012;8(4):434–9.

    Article  PubMed  Google Scholar 

  19. Musella M, Milone M, Bellini M, et al. Effect of bariatric surgery on obesity-related infertility. Surg Obes Relat Dis. 2012;8(4):445–9.

    Article  PubMed  Google Scholar 

  20. Dao T, et al. Pregnancy outcomes after gastric-bypass surgery. Am J Surg. 2006;192(6):762–6.

    Article  PubMed  Google Scholar 

  21. Kjaer MM, Nilas L. Timing of pregnancy after gastric bypass- a national register-based cohort study. Obes Surg. 2013;23:1281–5.

    Article  PubMed  Google Scholar 

  22. Patel JA, Patel NA, Thomas RL, Nelms JK, Colella JJ. Pregnancy outcomes after laparoscopic Roux-en Y gastric bypass. Surg Obes Relat Dis. 2008;4(1):39–45.

    Article  PubMed  Google Scholar 

  23. Weiss HG, Nehoda H, Labeck B, et al. Pregnancies after adjustable gastric banding. Obes Surg. 2001;11(3):303–6.

    Article  CAS  PubMed  Google Scholar 

  24. Printen KJ, Scott D. Pregnancy following gastric bypass for the treatment of morbid obesity. Am Surg. 1982;48(8):363–5.

    CAS  PubMed  Google Scholar 

  25. Centers of Disease Control and Prevention (CDC). U.S medical eligibility criteria for contraceptive use. MMWR Recomm Rep. 2010;59:1–86.

    Google Scholar 

  26. Maggard MA, Yermilov I, Li Z, et al. Pregnancy and fertility following bariatric surgery: a systematic review. JAMA. 2008;300:2286–96.

    Article  CAS  PubMed  Google Scholar 

  27. Jans G, Matthys C, Bogaerts A, et al. Maternal micronutrient deficiencies and related adverse neonatal outcomes after bariatric surgery: a systematic review. Adv Nutr. 2015;6:762–6.

    Article  Google Scholar 

  28. Lesko J, Peacman A. Pregnancy outcomes in women after bariatric surgery compared with obese and morbidly obese controls. Obstet Gynecol. 2012;119:547–54.

    Article  PubMed  Google Scholar 

  29. Loar PV, Sachez-Ramos L, Kaunitz A, et al. Maternal death caused by midgut volvulus after bariatric surgery. Am J Obstet Gynecol. 2005;193:1748–9.

    Article  PubMed  Google Scholar 

  30. American College of Obstetricians and Gynecologists. ACOG Committee Opinion N0. 656: guidelines for diagnostic imaging during pregnancy and lactation. Obstet Gynecol. 2016;127(2):e75–80.

    Article  Google Scholar 

  31. Carelli AM, Ren CJ, Youn HA, et al. Impact of laparoscopic adjustable gastric banding on pregnancy, maternal weight, and neonatal health. Obes Surg. 2011;21(10):1552–8.

    Article  PubMed  Google Scholar 

  32. Vrebosch L, Bel S, Vansant G, Guelinckx I, Devlieger R. Maternal and neonatal outcome after laparoscopic adjustable gastric banding: a systematic review. Obes Surg. 2012;22:1568–79.

    Article  CAS  PubMed  Google Scholar 

  33. Pilone V, Hasani A, Di Micco R, et al. Pregnancy after laparoscopic gastric banding: maternal and neonatal outcomes. Int J Surg. 2014;12:S136–9.

    Article  PubMed  Google Scholar 

  34. Miller K, Hell E. Laparoscopic adjustable gastric banding: a prospective 4-year follow-up study. Obes Surg. 1999;9:183–7.

    Article  CAS  PubMed  Google Scholar 

  35. Westling A, Bjurling K, Ohrvall M, Gustavsson S. Silicone adjustable gastric banding: disappointing results. Obes Surg. 1998;8:467–74.

    Article  CAS  PubMed  Google Scholar 

  36. Dogan UB, Akin MS, Yalaki S, Akova A, Yilmaz S. Endoscopic management of gastric band erosions: a 7-year series of 14 patients. Can J Surg. 2014;57(2):106–11.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Gochnour DC, Snyder BE, Wilson EB, Walker PA, Shah SK. Endoscopic removal of eroded adjustable gastric band in a pregnant patient. J Dig Endosc. 2015;6:126–9.

    Article  Google Scholar 

  38. Higa K, Ho T, Tercero F, Yunus T, Boone KB. Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up. Surg Obes Relat Dis. 2011;7:516–25.

    Article  PubMed  Google Scholar 

  39. Leal-Gonzalez R, De la Garza-Ramos R, Guajardo-Perez H, Ayala-Aguilera F, Rumbaul R. Internal hernias in pregnant women with history of gastric bypass surgery: case series and review of literature. Int J Surg Case Rep. 2012;4:44–7.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Scheirey CD, Scholz FJ, Shah PC, Brams DM, Wong BB, Pedrosa M. Radiology of the laparoscopic Roux-en-y gastric bypass procedure: conceptualization and precise interpretation of results. Radiographics. 2006;26:1355–71.

    Article  PubMed  Google Scholar 

  41. Hamdan K, Somers S, Chand M. Management of late postoperative complications of bariatric surgery. Br J Surg. 2011;98:1345–55.

    Article  CAS  PubMed  Google Scholar 

  42. Iannuccilli JD, Grand D, Murphy BL, Evangelista P, Roye GD, Mayo-Smith W. Sensitivity and specificity of eight CT signs in the preoperative diagnosis of internal mesenteric hernia following Roux-en-y gastric bypass surgery. Clin Radiol. 2009;64:373–80.

    Article  CAS  PubMed  Google Scholar 

  43. Lockhart ME, Tessler FN, Canon CL, Smith JK, Larrison MC, Fineberg NS, Roy BP, Clements RH. Internal hernia after gastric bypass: sensitivity and specificity of seven CT signs with surgical correlation and controls. AJR Am J Roentgenol. 2007;188(3):745–50.

    Article  PubMed  Google Scholar 

  44. Altieri MS, Pryor AD, Telem DA, Hall K, Brathwaite C, Zawin M. Algorithmic approach to utilization of CT scans for detection of internal hernia in the gastric bypass patient. Surg Obes Relat Dis. 2015;11(6):1207–11.

    Article  PubMed  Google Scholar 

  45. Jordan JH, Hocking MP, Rout WR, et al. Marginal ulcer following gastric bypass for morbid obesity. Am Surg. 1991;57:286–8.

    CAS  PubMed  Google Scholar 

  46. Sapala JA, Wood MH, Sapala MA, Flake TM Jr. Marginal ulcer after gastric bypass: a prospective 3-year study of 173 patients. Obes Surg. 1998;8(5):505–16.

    Article  CAS  PubMed  Google Scholar 

  47. Dallal RM, Bailey LA. Ulcer disease after gastric bypass surgery. Surg Obes Relat Dis. 2006;2:455–9.

    Article  PubMed  Google Scholar 

  48. Gumbs AA, Duffy AJ, Bell R. Incidence and management of marginal ulceration after laparoscopic Roux-Y gastric bypass. Surg Obes Relat Dis. 2006;2(4):460–3.

    Article  PubMed  Google Scholar 

  49. Lublin M, McCoy M, Waldrep DJ. Perforating marginal ulcers after laparoscopic gastric bypass. Surg Endosc. 2006;20(1):51–4.

    Article  CAS  PubMed  Google Scholar 

  50. Nava-Ocampo AA, Velázquez-Armenta EY, Han JY, Koren G. Use of proton pump inhibitors during pregnancy and breastfeeding. Can Fam Physician. 2006;52:853–4.

    PubMed  PubMed Central  Google Scholar 

  51. Gill SK, O’Brien L, Einarson TR, Koren G. The safety of proton pump inhibitors (PPIs) in pregnancy: a meta-analysis. Am J Gastroenterol. 2009;104(6):1541–5.

    Article  CAS  PubMed  Google Scholar 

  52. Essilfie P, Hussain M, Bolaji I. Perforated duodenal ulcer in pregnancy-a rare cause of acute abdominal pain in pregnancy: a case report and literature review. Case Rep Obstet Gynecol. 2011;2011:263016.

    PubMed  PubMed Central  Google Scholar 

  53. Marrero JM, Goggin PM, de Caestecker JS, et al. Determinants of pregnancy heartburn. Brit J Obstetr Gynaecol. 1992;99:731–4.

    Article  CAS  Google Scholar 

  54. Richter JE. Gastroesophageal reflux disease during pregnancy. Gastroenterol Clin N Am. 2003;32(1):235–61.

    Article  Google Scholar 

  55. Santoro S. Technical aspects in sleeve gastrectomy. Obes Surg. 2007;17:1534–5.

    Article  PubMed  Google Scholar 

  56. Rawlins L, Rawlins MP, Brown CC, Schumacher DL. Sleeve gastrectomy: 5-year outcomes of a single institution. Surg Obes Relat Dis. 2013;9(1):21–5.

    Article  PubMed  Google Scholar 

  57. Dupree CE, Blair K, Steele SR, Martin MJ. Laparoscopic sleeve gastrectomy in patients with preexisting gastroesophageal reflux disease: a national analysis. JAMA. 2014;149(4):328–34.

    Google Scholar 

  58. Himpens J, Dapri G, Cadiere GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16:1450–6.

    Article  PubMed  Google Scholar 

  59. Braghetto I, Csendes A, Korn O, Valladares H, Gonzalez P, Henriquez A. Gastroesophageal relux disease after sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech. 2010;20:148–53.

    Article  PubMed  Google Scholar 

  60. Burgerhart JS, Schotborgh C, Schoon EJ, et al. Effect of sleeve gastrectomy on gastroesophageal reflux. Obes Surg. 2014;24(9):1436–41.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, Stony Brook University Hospital, Stony Brook, NY, USA

    Maria S. Altieri & Aurora D. Pryor

Authors
  1. Maria S. Altieri
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  2. Aurora D. Pryor
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Correspondence to Aurora D. Pryor .

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Editors and Affiliations

  1. Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York, USA

    Diego Camacho

  2. Department of General Surgery, FIU Herbert Wertheim College of Medicine, Miami, Florida, USA

    Natan Zundel

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Altieri, M.S., Pryor, A.D. (2018). Pregnancy in the Bariatric Patient. In: Camacho, D., Zundel, N. (eds) Complications in Bariatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-75841-1_15

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  • DOI: https://doi.org/10.1007/978-3-319-75841-1_15

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-75840-4

  • Online ISBN: 978-3-319-75841-1

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