PREGNANCY FOLLOWING GASTRIC BYPASS FOR MORBID-OBESITY

Background: Women who suffer from morbid obesity are often infertile. If these women are able to become pregnant, they are considered high r isk because of the hypertension, diabetes and other associated risk fa ctors. Following the pregnancy is difficult due to limitations of the physical examinations. More costly ultrasound examinations are needed at a higher frequency. Bariatric surgery reduces the woman's weight an d the incidence of obesity related co-morbidities. The number of pregn ancies and rate of complications during those pregnancies in our post- bariatirc surgical patients were evaluated. Method: Our group has been doing bariatric surgery since the early 1980s. We have over 2000 acti ve patients on our current newsletter mailing list. The patients also have a series of networks through support groups. The patients are inf ormed to contact us when they become pregnant so we may assist the obs tetrician with their care. Through these various means, we have been a ble to identify 41 women in our patient population who have became pre gnant. Using personal interview, questionnaire, and review of perinata l records, pregnancy-related risks and complications were studied. Res ults: With over a 95% follow-up rate on the patients identified as hav ing been pregnant following surgery, we found less risk of gestational diabetes, macrosomia, and cesarean section than associated with obesi ty. There were no patients with clinically significant anemia. Conclus ion: Since the patients had an operation that restricts their food int ake, some basic precautions should be taken when they become pregnant. With this in mind, our patients have done well with their pregnancies . The post-surgical group had fewer pregnancy-related complications th an did an internally controlled group that were morbidly obese during their previous pregnancies. (C) 1998 Lippincott-Raven Publishers.