Managing Malnourishment in Pregnancy after Bariatric Surgery.


BACKGROUND Little information exists to guide monitoring and treatment of malnourishment during pregnancy after bariatric surgery. Here we present a case with severe deficiencies and recommendations for testing and treatment. CASE Our patient underwent a duodenal switch procedure resulting in significant weight loss and numerous deficiencies. She then experienced a neonatal demise with multiple congenital abnormalities, including diaphragmatic hernia, possibly related to severe vitamin A deficiency. After high doses of oral and parenteral replacement, pancreatic enzymes, and total parenteral nutrition, she delivered an anatomically normal but growth-restricted neonate in a subsequent pregnancy. CONCLUSION Bariatric procedures may result in nutritional deficiencies that affect pregnancy outcome. Women with severe deficiencies require pre-pregnancy counselling, monitoring, aggressive treatment, and a multidisciplinary approach to care.

DOI: 10.1016/j.jogc.2017.06.019

Cite this paper

@article{Harrison2017ManagingMI, title={Managing Malnourishment in Pregnancy after Bariatric Surgery.}, author={Rachel K Harrison and Charles Berkelhammer and V{\'i}ctor M. Gonz{\'a}lez Su{\'a}rez and Helen H. Kay}, journal={Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC}, year={2017} }