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BARIATRIC SURGERY IN PREGNANCY: BENEFITS, RISKS AND OBSTETRIC MANAGEMENT

Published online by Cambridge University Press:  04 April 2011

MUCHABAYIWA F GIDIRI  and
IAN A GREER
MUCHABAYIWA F GIDIRI*
Affiliation:
Department of Obstetrics and Gynaecology, University of Zimbabwe College of Health Sciences, Parirenyatwa Group of Hospitals and Mbuya Nehanda Maternity Hospital, Avondale, Harare, Zimbabwe.
IAN A GREER
Affiliation:
Faculty of Health and Life Sciences, University of Liverpool, The Foundation Building, Liverpool. United Kingdom.
*
Dr Muchabayiwa F Gidiri, Senior Lecturer and Consultant, University of Zimbabwe College of Health Sciences, Department of Obstetrics and Gynaecology, PO Box A178, Avondale, Harare, Zimbabwe. Email: fmgidiri@doctors.org.uk
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Extract

Obesity is a growing problem in obstetric practice. A recent study from Glasgow (UK) showed that 50% of women of childbearing age are either overweight (Body Mass Index [BMI] = 24.9–29.9kg/m2) or obese with 18% starting pregnancy as obese. Obesity prevalence has doubled over a decade from the early 1990’s. In the US it is estimated that 30% of reproductive-age women have a BMI greater than 30 kg/m while 7% have a BMI > 40 kg/m2. A recent report from the UK found that 5% of women had a BMI >35 kg/m2, 2% > 40 kg/m2 and 0.2% >50 kg/m2 with an association not only with social deprivation, but also with a higher prevalence of pre-existing medical disorders such as diabetes and hypertension and medical complications of pregnancy such as preeclampsia. Obesity was also associated with increased rates of macrosomia, operative delivery and postpartum haemorrhage. These data highlight the fact that obesity is an increasing health concern particularly in young women of childbearing age. Obesity will expose them to significant pregnancy complications ranging from miscarriage and fetal abnormality through to operative delivery and thromboembolism. There are also challenges for the delivery of maternity care to meet the needs of these women. As obesity is associated with significant pregnancy complications it is important that women enter pregnancy with an optimum body weight. Many complications, such as fetal abnormality occur in the first trimester and so pre-pregnancy weight reduction is preferred. Further, there is insufficient evidence to recommend specific dietary and/or physical activity interventions to reduce weight or moderate weight gain during pregnancy.

Type
Research Article
Information
Fetal and Maternal Medicine Review , Volume 22 , Issue 2 , May 2011 , pp. 109 - 122
Copyright
Copyright © Cambridge University Press 2011

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