Vol 92, No 3 (2021)
Review paper
Published online: 2021-02-10

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Intrauterine growth retardation after laparoscopic Roux-en-Y gastric bypass — clinical presentation and literature review

Anna Rozanska-Waledziak1, Joanna Kacperczyk-Bartnik1, Maciej Waledziak2, Pawel Bartnik1, Andrzej Kwiatkowski2, Justyna Teliga-Czajkowska1, Krzysztof Czajkowski1
Pubmed: 33576472
Ginekol Pol 2021;92(3):226-229.


Bariatric surgery is associated with a higher risk of intrauterine growth retardation (IUGR) and small for gestational age
neonates. We present two examples of IUGR after laparoscopic Roux-en-Y gastric bypass, both associated with excessive
restriction in patients caloric intake, one due to obstetrician’s indications and the other resulting from patient’s anxiety
of weight gain in pregnancy. IUGR was observed accordingly in the 35th and 28th week of pregnancy. The first patient
had an urgent cesarean section due to pathological cardiotocography tracings in the 35th week of pregnancy, with the
newborn’s weight of 1690 g (< 1st percentile). The second patient, admitted in the 28th week with suspected IUGR, had
an elective cesarean section in the 36th week, with the newborn’s weight of 2095 g (5th percentile). Although malabsorptive
mechanisms are known to be involved in the impaired fetal growth after bariatric surgery, patients’ and obstetricians’
adherence to nutrition and supplementation regimen are of utmost importance. The problem of optimum daily caloric
intake, vitamin and micronutrients supplementation in pregnancies after bariatric surgery is presently discussed in the
literature. Optimum care and advice for bariatric patients have to be diversified as malabsorptive and restrictive operations
lead to changes in metabolism, nutrition and hormonal balance.

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