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胃旁路手术后的妊娠:预期过程和结果如何?

Pregnancy following gastric bypass surgery: what is the expected course and outcome?

作者信息

Sapre Nikhil, Munting Karen, Pandita Archana, Stubbs Richard

机构信息

Wakefield Gastroenterology Centre, Private Bag 7909, Wellington, New Zealand.

出版信息

N Z Med J. 2009 Nov 20;122(1306):33-42.

Abstract

AIM

To examine the course of pregnancy, labour, and the neonatal period in a group of women who have become pregnant following gastric bypass surgery for severe obesity.

METHODS

Women who had experienced pregnancy following gastric bypass surgery were identified by an initial questionnaire. A second questionnaire was sent to those identified by the first questionnaire, who were willing to provide details concerning such pregnancies.

RESULTS

Seventeen women experienced a total of 24 pregnancies and 25 live births. Five had experienced difficulties with conception or pregnancy prior to surgery. The average maternal weight gain was 6.13 kg. No major problems with fetal growth were observed. Babies were delivered at a mean gestational age of 37.5 weeks and with a mean birth weight of 3038 g. Six women reported a complication during pregnancy (25%) and five a complication in labour (20%). Two babies born to the same mother had congenital abnormalities attributable to a rare genetic disorder.

CONCLUSION

The course of pregnancy and labour appears normalised for severely obese women following gastric bypass surgery. The weight loss and marked reduction in food intake following gastric bypass surgery does not lead to growth or development problems for offspring. Careful monitoring of expectant mothers who have undergone gastric bypass surgery is nevertheless to be recommended.

摘要

目的

研究一组因严重肥胖接受胃旁路手术后怀孕的女性的妊娠、分娩及新生儿期情况。

方法

通过初始问卷识别出胃旁路手术后怀孕的女性。向那些愿意提供此类妊娠详细信息的、由第一份问卷识别出的女性发送第二份问卷。

结果

17名女性共经历了24次妊娠和25次活产。5名女性在手术前受孕或妊娠有困难。孕妇平均体重增加6.13千克。未观察到胎儿生长的重大问题。婴儿平均在孕37.5周出生,平均出生体重为3038克。6名女性报告在孕期出现并发症(25%),5名女性在分娩时出现并发症(20%)。同一母亲所生的两名婴儿患有先天性异常,归因于一种罕见的遗传疾病。

结论

胃旁路手术后,严重肥胖女性的妊娠和分娩过程似乎正常化。胃旁路手术后的体重减轻和食物摄入量显著减少并未导致后代出现生长或发育问题。然而,仍建议对接受胃旁路手术的孕妇进行仔细监测。

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