Open AccessObstetrical risks before and after bariatric surgery
Author(s) -
Bogdan Maxim,
Corina Gică,
Radu Botezatu,
Anca Maria Panaitescu,
Anca Marina Ciobanu,
Brînduşa Ana Cimpoca-Raptis,
Gheorghe Peltecu,
Nicolae Gică,
Bucharest Pharmacy
Publication year - 2021
Publication title -
romanian journal of medical practice
Language(s) - English
Resource type - Journals
eISSN - 2069-6108
pISSN - 1842-8258
DOI - 10.37897/rjmp.2021.s3.3
Subject(s) - medicine , biliopancreatic diversion , gestational diabetes , surgery , sleeve gastrectomy , pregnancy , weight loss , obesity , body mass index , fetal macrosomia , duodenal switch , obstetrics , gastric banding , gestation , gastric bypass , biology , genetics
Obesity is defined as a body mass index (BMI) greater than 30 kg/m² and it is a major healthcare issue, with an increasing number of people being obese worldwide, including reproductive-aged women. Due to the great impact it has on morbidity and mortality, finding solutions to combat this century’s health menace became an issue and a necessity. Bariatric surgery is nowadays the treatment of choice for severe obesity due to the major weight loss following the procedure and improvements in several health outcomes. But as with all surgical procedures, it can also lead to complications, such as intestinal occlusions, with severe consequences, especially during pregnancy. Moreover, bariatric surgery can favor fetal growth restriction, depending on the type of procedure applied. There are two main types of bariatric surgery, purely restrictive procedures (sleeve gastrectomy, gastric banding) and malabsorptive or mixed procedures (biliopancreatic diversion, gastric bypass). Mixed procedures have been the first choice for many years because of the greater weight loss compared to gastric banding, but they can lead to nutritional deficiencies, with a potential impact on fetal development, causing an increased incidence of small-for-gestational-age fetuses (SGA). Main nutritional deficiencies include iron, vitamin B12, folate, and calcium. On the other hand, pregnant women who underwent bariatric surgery have lower risks of GDM (gestational diabetes mellitus), gestational hypertension and fetal macrosomia.