PREGNANCY FOLLOWING GASTRIC BYPASS-SURGERY FOR MORBID-OBESITY

Background: Surgical treatment for severe obesity is sometimes recomme nded. Many long-term risks, particularly to adolescents and to subsequ ent pregnancies, are still being determined. Case: A 23-year-old woman , gravida 6, para 2, treated for morbid obesity during adolescence wit h gastric bypass surgery, presented at 6 weeks' gestation with severe microcytic anemia. Significant iron and cobalamin deficiencies were fo und. Although the vitamin B-12 deficiency responded to parenteral trea tment, the iron deficiency was refractory to oral supplementation beca use of malabsorption. By 30 weeks' gestation, the patient required blo od transfusions to correct the progressive anemia. Subsequently, she d elivered a healthy male infant at term. Conclusion: Severe iron defici ency anemia resulting from malabsorption can complicate pregnancy foll owing gastric bypass surgery for morbid obesity. For women of childbea ring age, this potential adverse effect must be considered.