Pg Baharuddin Dg Marshitah, Payus Alvin Oliver, Abdel Malek Fahmy Ehab Helmy, Sawatan Waidah, Than Win Win, Abdelhafez Mohsen Ma, Oo Leik Nang Kham, Ag Daud D Maryama, Mohd Daud Mohd Nazri, Ahmad Zulkhairul Naim Sidek
Department of Obstetrics & Gynaecology, Faculty of Medicine & Health Science, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia.
Department of Medicine, Faculty of Medicine & Health Science, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia.
Ann Med Surg (Lond). 2021 Nov 11;72:103038. doi: 10.1016/j.amsu.2021.103038. eCollection 2021 Dec.
Bariatric procedures are on the rise as a surgical treatment for morbid obesity. In reproductive age of women, bariatric surgeries will improve factors related to anovulation and lead to spontaneous fertility. Spontaneous pregnancy can happen within a year after bariatric surgery due to higher level of sex hormone binding globulin and follicular stimulating hormone and reduction in androgens level. Reduction of length of follicular phase of menstrual cycle was reported and contribute to improved ovulatory status. The major impact to pregnant women is development of small for gestational age babies due to persistent weight loss but this can be minimized by avoiding pregnancies too soon after bariatric surgery and good nutrition supplement. Risk of developing gestational diabetes mellitus and preeclampsia reduced among post bariatric surgery compared to no surgery. Another benefit observed are reduction in the risk of caesarean section and admission to neonatal intensive care unit. There are no significant changes in composition of breast milk in postpartum women without bariatric surgery and with women whom undergone surgery although more study needed to evaluate this effect. Good prenatal care, micronutrient supplement during antenatal follow up and close supervision from expert managing this pregnancy are essential component to ensure good outcome to mothers and their newborn.
作为治疗病态肥胖的一种外科治疗方法，减肥手术正在兴起。在育龄女性中，减肥手术将改善与无排卵相关的因素，并导致自然受孕。由于性激素结合球蛋白和促卵泡生成素水平升高以及雄激素水平降低，减肥手术后一年内可能会自然怀孕。据报道，月经周期卵泡期长度缩短，这有助于改善排卵状态。对孕妇的主要影响是由于持续体重减轻导致小于胎龄儿的发育，但通过避免减肥手术后过早怀孕和良好的营养补充，这种情况可以降到最低。与未做手术相比，减肥手术后发生妊娠期糖尿病和先兆子痫的风险降低。观察到的另一个益处是剖宫产和入住新生儿重症监护病房的风险降低。未接受减肥手术的产后女性和接受过手术的女性的母乳成分没有显著变化，不过需要更多研究来评估这种影响。良好的产前护理、产前随访期间的微量营养素补充以及由管理该妊娠的专家进行密切监督，是确保母亲及其新生儿获得良好结局的重要组成部分。
