Schwangerschaft nach Adipositas- und metabolischer Chirurgie – spezielle Risiken und mögliche Komplikationen

Abstract

The increasing prevalence of morbid obesity in Germany is associated with an increasing number of metabolic surgical interventions. Short-term surgical and long-term metabolic complications - such as nutrient deficiencies - are the main risks of metabolic surgery and the resulting malabsorption. Obesity, especially morbid obesity, is associated with a high incidence of female infertility. One important cause of female infertility in obese women is the polycystic ovary syndrome, with 6 - 10%. Metabolic surgery significantly increases the fertility of obese women. The positive effect of obesity surgery on weight loss, remission of comorbidities, psychological outcome and fertility (in comparison with the effect of conservative treatment) has led to an increase in the number of metabolic operations. Nutrient deficiencies after restrictive, combined and malabsorptive procedures must be considered. Prophylaxis of these deficiencies during pregnancy after obesity surgery must be based on intensive interdisciplinary treatment. The aim of this overview is to characterise the metabolic complications and their prophylaxis, which are specific for the various bariatric procedures and which, subsequently, require temporary or permanent surveillance and supplementation.

Supplementation und Nachsorge nach Adipositas- und metabolischer Chirurgie

“…Frauen mit Kinderwunsch sollten präkonzeptionell eine höhere Mindestdosis von 600 mg Folsäure erhalten 7 , 8 ; eine entsprechende Aufklärung ist angeraten.…”

Schwangerschaftsbetreuung nach Adipositas- oder metabolischer Chirurgie

“…-Mortalität << 1 % -Morbidität 7-8 %: Fisteln der Klammernaht, Abszesse oder (Nach-)Blutungen ▪ postoperativ: Refluxkrankheit ▪ Schwangerschaft [15,16]:…”