The surgical management of obesity in young women: Consideration of the mother's and baby's health before, during, and after pregnancy

Department of Surgery, North Tyneside General Hospital, Northumbria Healthcare NHS Foundation Trust, Rake Lane, North Shields, Tyne & Wear NE29 8NH, England, UK.
Surgical Endoscopy (Impact Factor: 3.26). 08/2008; 22(10):2107-16. DOI: 10.1007/s00464-008-0019-5
Source: PubMed


Maternal obesity has a substantial associated morbidity and mortality affecting both mother and child. This has a major impact on provision of care due to increased requirements for both medical and surgical management of the consequences that follow obesity in pregnancy.
A review examined the English language literature on Medline databases describing the effect of obesity on pregnancy and outcomes of pregnancy after bariatric surgery. Guidelines from the National Institute for Clinical Excellence yielded information on selection criteria for fertility treatment and bariatric surgery. The World Health Organization definitions of overweight and obesity were adhered to throughout this review.
The level of clinical and morbid obesity has shown a dramatic increase in women of childbearing age, with far-reaching consequences for both their own health and that of their offspring. Obese women require a substantial amount of additional clinical care beyond that offered to women of normal weight due to the wide range of medical and obstetric complications they experience. Recent evidence suggests that obesity may be implicated in approximately one-third of maternal deaths. The consensus of the literature is that the best way to reduce obesity-associated morbidity is by weight reduction before pregnancy. Where behavioral and medical interventions fail, the most successful method is bariatric surgery. The effect of surgery on the outcome of subsequent pregnancies indicate improved chances of normal pregnancy, delivery, and healthy babies.
Bariatric surgery is a safe and effective method of weight loss for morbidly obese women of childbearing age, with favorable outcomes for pregnancies after surgery.

Download full-text


Available from: Melanie A. Grundy
  • Source
    • "Consistent with the importance for weight loss, most bariatric surgery has shown some beneficial [98, 99] effects on pregnancy outcomes in obese mothers and their neonates even though it was not the case in some other studies (as reviewed in [100]). Of note, bariatric surgery is also likely to affect patients' eating habits that contribute to improve obstetrical and neonatal complications in addition to weight loss. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Prepregnancy overweight or obesity and excessive gestational weight gain have been associated with increased risk of maternal and neonatal complications. Moreover, offspring from obese women are more likely to develop obesity, diabetes mellitus, and cardiovascular diseases in their lifetime. Gestational diabetes mellitus (GDM) is one of the most common complications associated with obesity and appears to have a direct impact on the future metabolic health of the child. Fetal programming of metabolic function induced by obesity and GDM may have intergenerational effect and thus perpetuate the epidemic of cardiometabolic conditions. The present paper thus aims at discussing the impact of maternal obesity and GDM on the developmental programming of obesity and metabolic disorders in the offspring. The main interventions designed to reduce maternal obesity and GDM and their ability to break the vicious circle that perpetuates the transmission of obesity and metabolic conditions to the next generations are also addressed.
    Full-text · Article · Oct 2011 · Experimental Diabetes Research
  • [Show abstract] [Hide abstract]
    ABSTRACT: A true 3-D ray tracing model has been developed for UWB propagation in a typical modern office. A time domain approach is used to determine all dominant paths by which radiation radiates from a transmitter to a receiving site. The number of rays that have to be considered can then be dramatically reduced for subsequent analyses. The properties of received power and delay spread as well as angle of arrival are presented. Each dominant path could then be represented by a function with these properties. Predictions of received waveform are produced by convolving a typical input UWB pulse with these functions. Hence, different input pulse characteristics can be applied to the transmit antenna and the receiver characteristics rapidly evaluated. The model also gives the transmission direction for each successful ray, which is difficult to measure in reality but essential to build the smart antenna.
    No preview · Conference Paper · Oct 2004
  • [Show abstract] [Hide abstract]
    ABSTRACT: Obesity poses a significant risk to reproductive-aged women. Weight reduction before conception is the best way to increasing fertility and reduces obesity associated morbidity. When medical interventions fail, bariatric surgery is the most successful method of weight loss, effective increasing fertility and reducing obstetrical complications and maternal and neonatal morbidity comparing obese women. Gastric banding and gastric bypass are the most increasingly utilized treatment option in France and should be offered to morbidly obese women of childbearing age. This literature review provides information about different techniques of bariatric surgery and about the multidisciplinary management of these pregnancies (monitoring, micronutrient supplementation) to promote maternal and fetal wellbeing in concert with continuing postoperative weight control.
    No preview · Article · Apr 2009 · Journal de Gynécologie Obstétrique et Biologie de la Reproduction
Show more