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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-Waledziak, Joanna Kacperczyk-Bartnik, Maciej Waledziak, Pawel Bartnik, Andrzej Kwiatkowski, Justyna Teliga-Czajkowska, Krzysztof Czajkowski
DOI: 10.5603/GP.a2020.0163
·
Pubmed: 33576472

open access

Ahead of Print
REVIEW PAPERS Obstetrics
Published online: 2021-02-10

Abstract

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.

Abstract

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.

Get Citation

Keywords

bariatric surgery; fetal growth retardation; avitaminosis

About this article
Title

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

Journal

Ginekologia Polska

Issue

Ahead of Print

Article type

Review paper

Published online

2021-02-10

DOI

10.5603/GP.a2020.0163

Pubmed

33576472

Keywords

bariatric surgery
fetal growth retardation
avitaminosis

Authors

Anna Rozanska-Waledziak
Joanna Kacperczyk-Bartnik
Maciej Waledziak
Pawel Bartnik
Andrzej Kwiatkowski
Justyna Teliga-Czajkowska
Krzysztof Czajkowski

References (15)
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