Hezelgrave N L, Oteng-Ntim Eugene
Maternal and Fetal Research Unit, Kings College London, St. Thomas' Hospital, Westminster Bridge Road, London SE1 7EH, UK.
J Obes. 2011;2011:501939. doi: 10.1155/2011/501939. Epub 2011 Jul 14.
Maternal obesity is a major cause of obstetric morbidity and mortality. With surgical procedures to facilitate weight loss becoming more widely available and demanded and increasing number of women becoming pregnant after undergoing bariatric surgery, it is important and timely to consider the outcome of pregnancy following bariatric surgery. This paper aims to synthesize the current evidence regarding pregnancy outcomes after bariatric surgery. It concludes that bariatric surgery appears to have positive effects on fertility and reduces the risk of gestational diabetes and preeclampsia. Moreover, there appears to be a reduced incidence of fetal macrosomia post-bariatric procedure, although there remains uncertainty about the increased rates of small-for-gestational age and intrauterine growth restricted infants, as well as premature rupture of membranes in this group. A number of case reports highlight that pregnancy following bariatric surgery is not without complications and it must be managed as high risk by the multidisciplinary team.
孕产妇肥胖是导致产科发病和死亡的主要原因。随着促进体重减轻的外科手术越来越普及且需求不断增加,越来越多的女性在接受减肥手术后怀孕,因此考虑减肥手术后的妊娠结局既重要又及时。本文旨在综合目前关于减肥手术后妊娠结局的证据。研究得出结论,减肥手术似乎对生育能力有积极影响,并降低了妊娠期糖尿病和先兆子痫的风险。此外,减肥手术后巨大儿的发生率似乎有所降低,尽管该组中小于胎龄儿和宫内生长受限婴儿的发生率增加以及胎膜早破的情况仍存在不确定性。一些病例报告强调,减肥手术后的妊娠并非没有并发症,多学科团队必须将其作为高危情况进行管理。