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Tuesday, May 10, 2005

Pregnancy After Weight Loss Surgery

When a woman in the child bearing years undergoes gastric bypass surgery one of the first things she will hear from the nay-sayers is that after surgery she cannot have a healthy pregnancy. The contrary is true. Morbid obesity results in a high rate of complicated pregnancies and a high rate of miscarriage.

In a study by Dr. Alan C. Wittgrove and nurse practitioner Leslie Jester from the Wittgrove Bariatric Center in San Diego patient follow-up indicates fewer risks during pregnancy after WLS than pregnancy in the morbidly obese.

On a personal note, I know both Dr. Wittgrove and Leslie Jester. Dr. Wittgrove, famous for doing Carnie Wilson’s surgery, performed my gastric bypass surgery one month after Carnie’s surgery. Leslie Jester was my nurse and counselor in the first three years following surgery. Leslie had a successful, healthy full-term pregnancy following her gastric bypass, AND she got her figure back – she is cute as a bug! Here is an article on their 1998 study:

Pregnancy following gastric bypass for morbid obesity.

Wittgrove AC, Jester L, Wittgrove P, Clark GW
Department of Surgery, Alvarado Hospital and Medical Center, San Diego, CA, USA.

BACKGROUND: Women who suffer from morbid obesity are often infertile. If these women are able to become pregnant, they are considered high risk because of the hypertension, diabetes and other associated risk factors. 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 and the incidence of obesity related co-morbidities. The number of pregnancies 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 active patients on our current newsletter mailing list. The patients also have a series of networks through support groups. The patients are informed to contact us when they become pregnant so we may assist the obstetrician with their care. Through these various means, we have been able to identify 41 women in our patient population who have become pregnant. Using personal interview, questionnaire, and review of perinatal records, pregnancy-related risks and complications were studied.

RESULTS: With over a 95% follow-up rate on the patients identified as having been pregnant following surgery, we found less risk of gestational diabetes, macrosomia, and cesarean section than associated with obesity. There were no patients with clinically significant anemia.

CONCLUSION: Since the patients had an operation that restricts their food intake, 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 than did an internally controlled group that were morbidly obese during their previous pregnancies.

Obes Surg 1998 Aug;8(4):461-4; discussion 465-6

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