Pregnancy After Gastric Sleeve Surgery
If you are a woman who has had gastric sleeve surgery and plan on getting pregnant or you already are pregnant, you probably have a lot of questions and concerns. Is it safe to get pregnant after gastric sleeve surgery? What are the potential complications for pregnancy after gastric sleeve surgery? How long should you wait to become pregnant after gastric sleeve surgery? Can you get pregnant after gastric sleeve surgery?
This article will help answer these questions and give you the information you need to know if you are pregnant or are planning on getting pregnant and have had gastric sleeve surgery.
What is gastric sleeve surgery?
Gastric sleeve surgery is a procedure where your surgeon creates a sleeve-shaped pouch by removing part of of your stomach. By significantly decreasing the size of your stomach, it restricts the amount that you can consume. This is why gastric sleeve surgery is considered a restrictive weight loss procedure.
The decrease in intake, which causes lower calorie consumption leads to significant weight loss in most patients. The most rapid weight loss occurs in the first 1 to 2 years following the surgery.
Women who are in the age range of having babies make up a large percentage of patients who have gastric sleeve surgery.
As a result, it is a common and important concern to question how gastric sleeve surgery could affect your pregnancy.
If you have had gastric sleeve surgery or are considering it, and you plan on getting pregnant eventually, it is important to understand how the procedure can affect your pregnancy.
There are many risk factors associated with obesity and pregnancy.
It is well known that obesity leads to many negative health problems. Obesity often causes infertility problems, but if you are obese and do become pregnant, there are many associated risks and possible negative outcomes. Some of these risks and possible negative outcomes include:
- Miscarriage or stillborn birth.
- Preeclampsia: a condition where the pregnant woman develops increased blood pressure during pregnancy and if undetected or untreated, it can lead to seizures, stroke, and even death.
- Gestational diabetes: a condition that develops during pregnancy and affects the amount of sugar in a woman’s blood. Insulin, a hormone that usually regulates the amount of sugar in the blood either does not work effectively or is not produced in a large enough amount to be effective. This leads to high blood sugar. Gestational diabetes can cause problems with both mom and baby, including a higher risk for having a c-section, preeclampsia, and having the baby too early. A woman with gestational diabetes also has a higher chance of developing diabetes after pregnancy and it increases the risk that the baby will have diabetes later in life.
- Low birth weight.
- Birth defects or abnormalities: most likely due to the decreased ability to read ultrasounds and other screening methods due to excess fat in an obese pregnant woman.
Weight loss from gastric sleeve surgery decreases the risks associated with obesity and pregnancy.
The good news is that weight loss decreases all of the above risks, including weight loss as a result of gastric sleeve surgery. If you have had gastric sleeve surgery, you may find that any fertility issues you had previously will resolve on their own. Because of this, it is important to use contraception until you are ready to become pregnant.
While weight loss decreases the risks associated with obesity and pregnancy, getting pregnant after gastric sleeve surgery does still have its own risks.
What are the risks of pregnancy after gastric sleeve surgery?
The most common pregnancy risks following gastric sleeve surgery are related to the rapid weight loss a woman experiences after the procedure, as well as common post-operative complications that may not be recognized because of the pregnancy.
Common risks and complications of pregnancy after gastric sleeve surgery include:
- Delayed or slowed growth of the baby: due to the pregnant woman not ingesting enough nutrients to support fetal growth because of decreased stomach size.
- Lack of proper nutrients for baby’s development: due to decreased intake as well as changes in nutrient-absorption in the woman, esp. vitamin B12, iron and calcium.
- Body image issues: some women have difficulty with the weight gain that results from pregnancy after the focus has been on losing weight from the gastric sleeve surgery.
- Post-surgical complications: complications from gastric sleeve surgery, such as obstructions or leaks can be masked by normal pregnancy symptoms, such as nausea, vomiting, and abdominal discomfort. This can delay urgent care that is needed if the symptoms are actually due to surgical complications.
How long should you wait to get pregnant after gastric sleeve surgery?
The weight loss that you experience following gastric sleeve surgery leads to many health improvements, including increased fertility. While it is possible to get pregnant very quickly after weight loss surgery, current recommendations encourage waiting for at least 12 to 18 and as long as 24 months following any weight loss surgery, including gastric sleeve surgery. This is because the most rapid weight loss happens in this time period, and can have negative effects on your developing baby if you become pregnant before your weight has stabilized.
What if you get pregnant less than 12 months after gastric sleeve surgery?
If you are pregnant and had gastric sleeve surgery less than 12 months ago, don’t panic. While considered a high-risk pregnancy, most outcomes are still positive, even when a woman becomes pregnant sooner than 12 months after gastric sleeve surgery.
The most important factor is close follow up by a team of doctors and specialists.
This includes your ob-gyn, surgeon, nutritionist, and any other specialists that are referred or recommended to help ensure the best possible outcome for you and your baby.
What should you expect if you become pregnant after having a gastric sleeve surgery?
If you have had gastric sleeve surgery and are pregnant, you can expect to be closely monitored by a team of doctors and specialists. You will probably have more frequent appointments than a woman who has not had weight loss surgery. During your pregnancy, the following will be very important:
- Managing nausea and vomiting.
- Proper nutrition, including small, frequent meals.
- Monitoring micronutrients. Iron, Calcium, Vitamin D, folic acid, Vitamin B12, Vitamin A, and thiamine are all vital to baby’s development. Because of your decreased intake, you may be lacking in some or all of these and may need supplements to ensure proper development of your baby.
- Avoiding alcohol. It's important to avoid drinking alcohol during any pregnancy, but doubly so when you've had gastric sleeve surgery.
Pregnancy is a time to be excited and happy while you anticipate the arrival of your little bundle of joy.
Pregnancy after gastric sleeve surgery does not have to be any different. With extra monitoring and close follow up with your team of health care professionals, and by carefully following nutritional recommendations, pregnancy after gastric sleeve surgery should have the same joyous outcome.
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3345131/
https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/gastric-sleeve-surgery
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5018021/
https://www.acog.org/Patients/FAQs/Obesity-and-Pregnancy?IsMobileSet=false