13.12.2018

First Lose Weight, And Then Get Pregnant!

According to the latest S3 guideline on the diagnosis and treatment “Bariatric Surgery and Metabolic Diseases,” a planned pregnancy is definitely not a contraindication for metabolic or bariatric surgery. However, experts advise to maintain a sufficient time interval between surgery and conception.

“After surgery, during the period of weight loss all patients need to use contraception, regardless of whether they wish to have children or not,” explains Dr. Ulf Elbelt, a diabetologist at the Charité. The reason is the possible lack of nutrients in the expectant mother and the fetus. The period of losing weight takes different time. The new guideline says that an approximate duration of the weight loss phase after bariatric surgery with particular risks for the future mother and the fetus is two years.

“Only taking birth control pills for reliable contraception is not enough,” says Dr. Elbelt. After such an intervention, it can lead to diarrhea and vomiting with insufficient absorption of steroids. After bypassing a part of the small intestine, sufficient absorption cannot be guaranteed either. Patients should consult the attending gynaecologist and choose the best suitable contraception. There is no general recommendation concerning it in the guideline.

If it was not possible to avoid pregnancy during the period of weight loss, the guideline recommends the following:

  • Do not continue losing weight (i.e. do not hasten it with liquid nutrition);
  • take a multivitamin complex that needs to be chosen according to the malabsorption associated with a particular type of bariatric surgery;
  • when bandaging the stomach the bandage may weaken;
  • regular monitoring of metabolism and gynaecological surveillance.

In some cases, additional tests are required to detect diabetes in pregnant women after bypass surgery. They must be performed with the gynaecologist’s and endocrinologist’s consent.

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