Available online 1 June 2023, 102614

Author links open overlay panel, , ABSTRACTBackground

: Obesity is a rising world-wide problem and bariatric surgery, also in the reproductive age, is increasingly performed. Bariatric procedures are associated with surgical complications during pregnancy, such as internal herniation.

Cases

: In this case series three cases with severe surgical complications after Roux-Y gastric bypass are described. In all three cases surgery was needed to prevent further complications. In one case subtotal bowel resection had to be performed because of extensive necrosis and intra-uterine fetal death was found.

Conclusion

: Though surgical complications after Roux-Y gastric bypass are not very common, complications can be very serious and lead to severe morbidity and even mortality for mother and fetus. Because of the severity of complications, delaying bariatric surgery or considering alternative bariatric techniques with fewer (severe) complications should be considered in obese women in childbearing age.

Section snippetsINTRODUCTION

Obesity is an increasing world-wide problem. In 2020, 50.0% of the Dutch population of 18 years and older was overweight (BMI ≥25) and 13.9% was obese (BMI ≥ 30).[1] Bariatric surgery is a very effective method to obtain significant weight loss and thereby a reduction of related health issues. Since fertility improves significantly in women who lost a sufficient amount of weight after bariatric surgery, bariatric surgery in the reproductive age, and thus pregnancy after bariatric surgery has

DISCUSSION

Bariatric surgery is increasingly often performed in women in the reproductive age. In our Dutch teaching hospital, the number of pregnant women with prior bariatric surgery is rising. In 2021, a total of 31 pregnant women with prior bariatric surgery were seen in 1300 deliveries that year (24 women with prior RYGB and 7 women with prior laparoscopic sleeve gastrectomy (LSG)). In contrast, in 2015 the number of women with prior RYGB was 5, while no women were seen with prior LSG. With the

Funding sources

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Acknowledgements

None

References (30)V Vannevel et al.Internal herniation in pregnancy after gastric bypass

Obstetrics and Gynecology. Lippincott Williams and Wilkins

(2016)

I Guelinckx et al.Reproductive outcome after bariatric surgery: A critical review

Vol.

(2009)

A Paroz et al.Internal Hernia after Laparoscopic Roux-en-Y Gastric Bypass for Morbid Obesity: A Continuous Challenge in Bariatric Surgery

Obes Surg

(2006)

MB Goldberg et al.Petersen's Hernia after Laparoscopic Roux-en-Y Gastric Bypass Presenting in Second Tri-mester Pregnancy

JSM Gastroenterol Hepatol

(2017)

DS Bonouvrie et al.The Acute Abdomen in Pregnant Women After Roux-en-Y Gastric Bypass: Encouraging Results from a National Referral Centre

Obes Surg [Internet]

(2020)

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