Cardiac Output, Venous Return, and Their Regulation
A Matter of Timing—Pregnancy After Bariatric Surgery.ppt
1. 1
A Matter of Timing—Pregnancy After
Bariatric Surgery
Dr. Hiwa Omer Ahmed
Professor in General and Bariatric
surgery
University of Sulaimani
College of Medicine – Sulaimani city-
Kurdistan
2. 2
More than half of all female patients
undergoing bariatric surgery are of
reproductive age.
3. 3
Risk period
There are risks may which are most
pronounced in pregnancies within the first
12 months after surgery as this period
theoretically carries the highest risk of
malnutrition due to a markedly reduced
caloric intake and rapid weight loss
4. 4
Time not allowed for pregnancy
American Society for Metabolic and Bariatric
Surgery (ASMBS), claimed pregnancy should be
avoided for 12–18 months following bariatric
surgery (2013)
American College of Obstetricians and
Gynecologists proposes a wider time interval of
12–24 months postsurgery (2009, reconfirmed
2019)
5. 5
Pros of Bariatric surgery
regarding pregnancy
Weight loss after bariatric surgery
1. improves fertility
2. Reduces the risk of gestational diabetes (GDM)
3. Hypertensive disorders
4. Large -for-gestational-age (LGA) neonates
6. 6
Cons of bariatric surgery
regaerding pregnancy
infants born after maternal bariatric surgery may be at risk for
1. Preterm birth
2. Admission to the neonatal intensive care
unit
3. Being small-for-gestational-age (SGA)
4. It reduces gestational weight gain
7. 7
It reduces gestational weight gain
Gestational weight gain below the lower limit of 5 kg is associated
with
1. an increased risk of small-for-gestational-
age SGA neonates
2. decreased neonatal birth weight, fat mass,
lean mass, birth length, and head
circumference
8. 8
The recommendation
To postpone pregnancy at least for 12 months after bariatric
surgery.
During pregnancy, specific attention is needed on achieving
adequate gestational weight gain.
