Management of Pregnancy in Women Who Have Undergone Bariatric Surgery. 2016

Cara Dolin, and Akuezunkpa O Ude Welcome, and Aaron B Caughey
Maternal-Fetal Medicine Fellow, Department of Obstetrics and Gynecology, New York University Langone Medical Center, New York, NY.

OBJECTIVE As the problem of obesity continues to grow, more patients are choosing to undergo bariatric surgery to lose weight and treat comorbidities, such as diabetes. Of the more than 200,000 procedures performed each year, 80% are in women, many of reproductive age. Taking care of a pregnant woman who has undergone bariatric surgery requires understanding of the risks, the need for additional surveillance, and the limitations of our knowledge about how bariatric surgery affects pregnancy. OBJECTIVE The aims of this study were to review the current literature on bariatric surgery and pregnancy and summarize the important evidence to help the obstetrician care for a pregnant woman after bariatric surgery. METHODS Evidence for this review was acquired using PubMed. CONCLUSIONS Pregnancy after bariatric surgery is safe and may be associated with improved pregnancy outcomes; however, more research is needed to better understand how to manage pregnant women with a history of bariatric surgery. CONCLUSIONS Obstetricians will increasingly be caring for women who have undergone bariatric surgery and subsequently become pregnant.

UI MeSH Term Description Entries
D009765 Obesity A status with BODY WEIGHT that is grossly above the recommended standards, usually due to accumulation of excess FATS in the body. The standards may vary with age, sex, genetic or cultural background. In the BODY MASS INDEX, a BMI greater than 30.0 kg/m2 is considered obese, and a BMI greater than 40.0 kg/m2 is considered morbidly obese (MORBID OBESITY).
D010346 Patient Care Management Generating, planning, organizing, and administering medical and nursing care and services for patients. Care Management, Patient,Management, Patient Care
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011248 Pregnancy Complications Conditions or pathological processes associated with pregnancy. They can occur during or after pregnancy, and range from minor discomforts to serious diseases that require medical interventions. They include diseases in pregnant females, and pregnancies in females with diseases. Adverse Birth Outcomes,Complications, Pregnancy,Adverse Birth Outcome,Birth Outcome, Adverse,Complication, Pregnancy,Outcome, Adverse Birth,Pregnancy Complication
D011256 Pregnancy Outcome Results of conception and ensuing pregnancy, including LIVE BIRTH; STILLBIRTH; or SPONTANEOUS ABORTION. The outcome may follow natural or artificial insemination or any of the various ASSISTED REPRODUCTIVE TECHNIQUES, such as EMBRYO TRANSFER or FERTILIZATION IN VITRO. Outcome, Pregnancy,Outcomes, Pregnancy,Pregnancy Outcomes
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D050110 Bariatric Surgery Surgical procedures aimed at affecting metabolism and producing major WEIGHT REDUCTION in patients with MORBID OBESITY. Bariatric Surgeries,Bariatric Surgical Procedures,Metabolic Surgery,Stomach Stapling,Bariatric Surgical Procedure,Metabolic Surgeries,Procedure, Bariatric Surgical,Procedures, Bariatric Surgical,Stapling, Stomach,Surgeries, Bariatric,Surgeries, Metabolic,Surgery, Bariatric,Surgery, Metabolic,Surgical Procedure, Bariatric,Surgical Procedures, Bariatric
D020379 Risk Adjustment The use of severity-of-illness measures, such as age, to estimate the risk (measurable or predictable chance of loss, injury or death) to which a patient is subject before receiving some health care intervention. This adjustment allows comparison of performance and quality across organizations, practitioners, and communities. (from JCAHO, Lexikon, 1994) Case-Mix Adjustment,Adjustment, Case-Mix,Adjustment, Risk,Adjustments, Case-Mix,Adjustments, Risk,Case Mix Adjustment,Case-Mix Adjustments,Risk Adjustments

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