Harrison Rachel K, Berkelhammer Charles, Suarez Victor, Kay Helen H
Department of Obstetrics and Gynecology, University of Illinois at Chicago, Chicago, IL.
Department of Gastroenterology, Advocate Christ Medical Center, Oak Lawn, IL.
J Obstet Gynaecol Can. 2018 Feb;40(2):211-214. doi: 10.1016/j.jogc.2017.06.019. Epub 2017 Sep 1.
Little information exists to guide monitoring and treatment of malnourishment during pregnancy after bariatric surgery. Here we present a case with severe deficiencies and recommendations for testing and treatment.
Our patient underwent a duodenal switch procedure resulting in significant weight loss and numerous deficiencies. She then experienced a neonatal demise with multiple congenital abnormalities, including diaphragmatic hernia, possibly related to severe vitamin A deficiency. After high doses of oral and parenteral replacement, pancreatic enzymes, and total parenteral nutrition, she delivered an anatomically normal but growth-restricted neonate in a subsequent pregnancy.
Bariatric procedures may result in nutritional deficiencies that affect pregnancy outcome. Women with severe deficiencies require pre-pregnancy counselling, monitoring, aggressive treatment, and a multidisciplinary approach to care.
关于减肥手术后孕期营养不良的监测和治疗，可供参考的信息很少。在此，我们介绍一个存在严重营养素缺乏的病例，并给出检测和治疗建议。
我们的患者接受了十二指肠转位手术，体重显著减轻，并出现多种营养素缺乏。随后，她经历了新生儿死亡，新生儿有多种先天性异常，包括膈疝，这可能与严重的维生素A缺乏有关。在给予高剂量的口服和肠外补充剂、胰酶以及全肠外营养后，她在随后的一次妊娠中分娩出一名解剖结构正常但生长受限的新生儿。
减肥手术可能导致影响妊娠结局的营养缺乏。存在严重营养素缺乏的女性需要在孕前接受咨询、监测、积极治疗，并采用多学科护理方法。
