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Management of Pregnancy in Women Who Have Undergone Bariatric Surgery

Dolin, Cara MD; Ude Welcome, Akuezunkpa O. MD; Caughey, Aaron B. MD, PhD

Obstetrical & Gynecological Survey: December 2016 - Volume 71 - Issue 12 - p 734–740
doi: 10.1097/OGX.0000000000000378
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Importance 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.

Evidence Acquisition 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.

Relevance Obstetricians will increasingly be caring for women who have undergone bariatric surgery and subsequently become pregnant.

Target Audience Obstetricians and gynecologists, family physicians.

Learning Objectives After participating this activity, the learner should be better able to understand the indications for bariatric surgery and how different types of bariatric procedures change gastrointestinal physiology and nutrient metabolism; appropriately counsel patients about the risks and benefits of pregnancy after bariatric surgery; and understand the importance of monitoring nutritional status and supplementation in pregnancies after bariatric surgery.

*Maternal-Fetal Medicine Fellow, Department of Obstetrics and Gynecology, New York University Langone Medical Center, New York, NY; †Assistant Professor, Department of Surgery, New York University Langone Medical Center, New York, NY; and ‡Professor and Chair, Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR

All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.

Correspondence requests to: Cara Dolin, MD, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, New York University Langone Medical Center, NBV-9E2 462 1st Ave, New York, NY 10016. E-mail: Cara.Dolin@nyumc.org.

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