Bariatric surgery can help obese women achieve successful pregnancy – but should only be a last resort, obstetricians say today.
Lifestyle changes should be tried first when young women are obese – but surgery could be offered if this fails, according to the Royal College of Obstetricians and Gynaecologists.
The college analysis says that bariatric surgery can improve fertility and reproductive outcomes for obese women.
It says that bariatric surgery improves the signs and symptoms of polycystic ovary syndrome as well as hormonal balance and libido.
It says most research has shown improved maternal and infant outcomes, including reduced risk of miscarriage, of gestational diabetes, hypertension, macrosomia and congenital abnormalities.
But there is an increased risk of preterm birth and of small babies.
The researchers say that women who get pregnant after surgery will need specialist care, including weight monitoring, close observation of foetal growth and monitoring for gestational diabetes.
Professor Adam Balen, from the college, said: “Our review of all the literature on this subject confirms that weight loss surgery can improve fertility and reproductive outcomes in obese women, but we believe it should only be considered as a last resort when other treatments, such as lifestyle changes, haven’t worked.
“As with any major operation, bariatric surgery carries a risk of complications but also requires a significant change in lifestyle afterwards. As well as the time needed to recover from the surgery, it can delay conception by up to 12 to 18 months during the initial weight loss phase, because the foetus may be at risk of nutritional deficiencies.
Additionally, there is very limited access to these types of interventions on the NHS and the demand is currently higher than supply in many areas of the country."
The chair of the college’s scientific advisory committee Dr Sadaf Ghaem-Maghami said: “As with any operation, bariatric surgery is associated with some risks and complications can include infection, protein malnutrition, deep vein thrombosis and hernia. An increased rate of small for gestational age babies and preterm birth has also been documented in some research.
“It is therefore vital that when bariatric surgery is considered an option and is available for women who wish to improve their chance of conceiving naturally or through assisted means, they speak to their obstetrician and surgeon to balance the risks of surgery against the benefits of improved long-term health and wellbeing for themselves and their future children.”
Leave a Reply