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Minimally Invasive Bariatric Surgery pp 495–500Cite as

The Female Patient: Pregnancy and Gynecologic Issues in the Bariatric Surgery Patient

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Abstract

Polycystic ovary syndrome (PCOS) affects nearly 7% of reproductive age females (1). The syndrome was initially named Stein-Leventhal syndrome for the physicians who recognized in 1935 a clinical triad of hirsutism, amenorrhea, and obesity. Since then, the National Institutes of Health (NIH) has updated this definition to: “amenorrhea and hyperandrogenism, existing after the exclusion of all the secondary causes.” The etiology of PCOS remains unclear, although there are a number of theories, including obesity as a prominent hypothesis. One theory suggests increased gonadotropin-releasing hormone (GnRH) pulsatility as the culprit, and another theory points to ovarian dysfunction and dysregulation of androgen synthesis (2). The role of genetics in PCOS is similarly uncertain.

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References

  1. Franks S. Polycystic Ovary Syndrome. N Engl J Med 1995; 333:853–861.

    Article  CAS  PubMed  Google Scholar 

  2. Poretsky L. The insulin related ovarian regulatory system in health and disease. Endocr Rev 1999;20:535–582.

    Article  CAS  PubMed  Google Scholar 

  3. Patel SR, Korytkowski MT. Polycystic ovary syndrome: How best to establish the diagnosis. Women’s Health in Primary Care 2000;3:55–67.

    Google Scholar 

  4. Rogerio CL. Importance of diagnosing the polycystic ovary syndrome. Ann Intern Med 2000;132:989–993.

    Article  Google Scholar 

  5. Legro R. The genetics of obesity: Lessons for polycystic ovary syndrome. Ann NY Acad Sci 2000;900:193–202.

    Article  CAS  PubMed  Google Scholar 

  6. Hoeger K. Obesity and weight loss in polycystic ovary syndrome. Obstet Gynecol Clin North Am 2001;28:85–97.

    Article  CAS  PubMed  Google Scholar 

  7. Futterweit W. Polycystic ovary syndrome: clinical perspectives and management. Obstet Gynecol Surv 1999;54:403–413.

    Article  CAS  PubMed  Google Scholar 

  8. Diamanti-Kandarakis E, Zapatni E. Insulin sensitizers and antiandrogens in the treatment of polycystic ovary syndrome. Ann NY Acad Sci 2000;900:203–212.

    Article  CAS  PubMed  Google Scholar 

  9. Hollmann M, Runnebaum B, Gerhard I. Effects of weight loss on the hormonal profile in obese infertile women. Hum Reprod 1996;11:1884–1891.

    Article  CAS  PubMed  Google Scholar 

  10. Pasquali R, Antenucci D, Casimirri F, et al. Clinical and hormonal characteristics of obese amenorrheic hyperandrogenic women before and after weight loss. J Clin Endocrinol Metab 1989;68:173–179.

    Article  CAS  PubMed  Google Scholar 

  11. Kopelman PG, White N, Pilkington TRE, et al. The effect of weight loss on sex steroid secretion and binding in massively obese women. Clin Endocrinol 1981;15:113–116.

    Article  CAS  Google Scholar 

  12. Dixon JB, Dixon ME, O’Brien PE. Birth outcomes in obese women after laparoscopic adjustable gastric banding. Obstet Gynecol 2005;106:965–972.

    Article  PubMed  Google Scholar 

  13. Schauer PR, Ikramuddin S. Laparoscopic surgery for morbid obesity. Surg Clin North Am 2001;81:1145–1179.

    Article  CAS  PubMed  Google Scholar 

  14. Favretti F, Cadiere GB, Segato G, et al. Laparoscopic banding: selection and technique in 830 Patients. Obes Surg 2002;12:385–390.

    Article  CAS  PubMed  Google Scholar 

  15. Pories WJ, Swanson MS, MacDonald KG, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 1995;222:339–352.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. O’Brien PE, Brown WA, Smith A, McMurrick PJ, Stephens M. Prospective study of a laparoscopically placed, adjustable gastric band in the treatment of morbid obesity. Br J Surg 1999;85:113–118.

    Article  Google Scholar 

  17. Eid GM, Cottam DR, Velcu LM, et al. Effective treatment of polycystic ovarian syndrome with Roux-en-Y gastric bypass. Surg Obes Relat Dis 2005;1:77–80.

    Article  PubMed  Google Scholar 

  18. Johnson JWC, Longmate JA, Frentzen B. Excessive maternal weight and pregnancy outcome. Am J Obstet Gynecol 192;167:353–372.

    Google Scholar 

  19. Printen KJ, Scott D. Pregnancy following gastric bypass for the treatment of morbid obesity. Am Surg 1982;8:363–365.

    Google Scholar 

  20. Richards DS, Miller DK, Goodman GN Pregnancy after gastric bypass for morbid obesity. J Reprod Med 1987;32: 172–176.

    CAS  PubMed  Google Scholar 

  21. Wittgrove AC, Jester L, Wittgrove P, et al. Pregnancy following gastric bypass for morbid obesity. Obes Surg 1998;8:461–464; discussion 465–466.

    Article  CAS  PubMed  Google Scholar 

  22. Bilenka B, Ben-Shlomo I, Cozacov C, et al. Fertility, miscarriage, and pregnancy after vertical banded gastroplasty operation for morbid obesity. Acta Obstet Gynecol Scand 1995;74:42–44.

    Article  CAS  PubMed  Google Scholar 

  23. Martin LF, Finigan KM, Nolan TE. Pregnancy after adjustable gastric banding. Obstet Gynecol 2000;95(6 pt 1):927–930.

    Article  CAS  PubMed  Google Scholar 

  24. Weiss HG, Nehoda H, Labeck B, et al. Pregnancies after adjustable gastric banding. Obes Surg 2001;11(3):303–306.

    Article  CAS  PubMed  Google Scholar 

  25. Dixon JB, Dixon ME, O’Brien PE. Pregnancy after Lap-Band surgery: management of the band to achieve healthy weight outcomes. Obes Surg 2001;11:59–65.

    Article  CAS  PubMed  Google Scholar 

  26. Granstrom L, Granstrom L, Backman L. Fetal growth retardation after gastric banding. Acta Obstet Gynecol Scand 1990;69:533–536.

    Article  CAS  PubMed  Google Scholar 

  27. Friedman D, Cuneo S, Valenzano M, et al. Pregnancies in an 18-year follow-up after biliopancreatic diversion. Obes Surg 1995;5:308–313.

    Article  PubMed  Google Scholar 

  28. Marceau P, Kaufman D, Biron S, et al. Outcome of pregnancy after biliop ancre atic diversion. Obes Surg 2004;14: 318–324.

    Article  PubMed  Google Scholar 

  29. Charles A, Domingo S, Goldfadden A, et al. Small bowel ischemia after Roux-en-Y gastric bypass complicated by pregnancy: a case report. Am Surg 2005;71:231–234.

    PubMed  Google Scholar 

  30. Kakarla N, Dailey C, Marino T, et al. Pregnancy after gastric bypass surgery and internal hernia formation. Obstet Gynecol 2005;105:1195–1198.

    Article  PubMed  Google Scholar 

  31. Moore KA, Ouyang W, Whang EE. Maternal and fetal deaths after gastric bypass surgery for morbid obesity. N Engl J Med 2004;351:721–722.

    Article  CAS  PubMed  Google Scholar 

  32. Ott MT, Fanti P, Malluche H, et al. Biochemical evidence of metabolic bone disease in women following Roux-Y gastric bypass for morbid obesity. Obes Surg 1992;2; 341–348.

    Article  PubMed  Google Scholar 

  33. Goldner WS, O’Dorisio TM, Dillon JS, et al. Severe metabolic bone disease as a long-term complication of obesity surgery. Obes Surg 2002;12:685–692.

    Article  PubMed  Google Scholar 

  34. Werler MM, Louik C, Shapiro S, et al. Prepregnant weight in relation to risk of neural tube defects. JAMA 1996;275: 1089–1092.

    Article  CAS  PubMed  Google Scholar 

  35. Haddow JE, Hill LE, Kloza EM, et al. Neural tube defects after gastric bypass. Lancet 1986;1:1330.

    Article  CAS  PubMed  Google Scholar 

  36. Knudsen LB, Kallen B. Gastric bypass, pregnancy, and neural tube defects. Lancet 1986;2:227.

    Article  CAS  PubMed  Google Scholar 

  37. Martin L, Chavez GF, Adams MJ Jr, et al. Gastric bypass surgery as maternal risk factor for neural tube defects. Lancet 1988;1:640–641.

    Article  CAS  PubMed  Google Scholar 

  38. Mommsen S, Foldspang, A. Body mass index and adult female urinary incontinence. World J Urol 1994;12:319–322.

    Article  CAS  PubMed  Google Scholar 

  39. Hannestad YS, Rortveit G, Daltveit AK, Hunskaar S. Are smoking and other lifestyle factors associated with female urinary incontinence? The Norwegian EPINCONT Study. Bjog 2003;110:247–254.

    Article  PubMed  Google Scholar 

  40. Bai SW, Kang JY, Rha KH, et al. Relationship of urodynamic parameters and obesity in women with stress urinary incontinence. J Reprod Med 2002;47:559–563.

    PubMed  Google Scholar 

  41. Noblett KL, Jensen, JK, Ostergard DR. The relationship of body mass index to intra-abdominal pressure as measured by multichannel cystometry. Int Urogynecol J Pelvic Floor Dysfunct 1997;8:323–326.

    Article  CAS  PubMed  Google Scholar 

  42. Dwyer PL, Lee ET, Hay DM. Obesity and urinary incontinence in women. Br J Obstet Gynaecol 1988;95:91–96.

    Article  CAS  PubMed  Google Scholar 

  43. Kolbl H, Riss P. Obesity and stress urinary incontinence: significance of indices of relative weight. Urol Int 1988;43: 7–10.

    Article  CAS  PubMed  Google Scholar 

  44. Subak LL, Johnson C, Whitcomb E, et al. Does weight loss improve incontinence in moderately obese women? Int Urogynecol J Pelvic Floor Dysfunct 2002;13:40–43.

    Article  CAS  PubMed  Google Scholar 

  45. Deitel M, Stone E, Kassam HA, et al. Gynecologicobstetric changes after loss of massive excess weight following bariatric surgery. J Am Coll Nutr 1988;7:147–153.

    Article  CAS  PubMed  Google Scholar 

  46. Mukherjee K, Constantine G. Urinary stress incontinence in obese women: tension-free vaginal tape is the answer. BJU Int 2001;88:881–883.

    Article  CAS  PubMed  Google Scholar 

  47. Brieger G, Korda A. The effect of obesity on the outcome of successful surgery for genuine stress incontinence. Aust N Z J Obstet Gynaecol 1992;32:71–72.

    Article  CAS  PubMed  Google Scholar 

  48. Zivkovic F, Tamussino K, Pieber D. et al. Body mass index and outcome of incontinence surgery. Obstet Gynecol 1999; 93:753–756.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, Magee-Women’s Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Giselle Hamad MD (Assistant Professor, Medical Director of Minimally Invasive General Surgery and Bariatrics) & George M. Eid MD (Assistant Professor)

Authors
  1. Giselle Hamad MD
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  2. George M. Eid MD
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Editor information

Editors and Affiliations

  1. Lerner College of Medicine, USA

    Philip R. Schauer MD (Professor of Surgery) (Professor of Surgery)

  2. Advanced Laparoscopic and Bariatric Surgery, Bariatric and Metabolic Institute The Cleveland Clinic Foundation, Cleveland, OH, 44195, USA

    Philip R. Schauer MD (Professor of Surgery) (Professor of Surgery)

  3. Department of Surgery Health Sciences Center, University of Virginia Health System, Charlottesville, VA, 22908, USA

    Bruce D. Schirmer MD (Stephen H. Watts Professor of Surgery) (Stephen H. Watts Professor of Surgery)

  4. Advanced Laparoscopic and Bariatric Surgery, Department of Surgery, The Cleveland Clinic Foundation, Cleveland, OH, USA

    Stacy A. Brethauer MD (Staff Surgeon) (Staff Surgeon)

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© 2007 Springer Science+Business Media, LLC

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Hamad, G., Eid, G.M. (2007). The Female Patient: Pregnancy and Gynecologic Issues in the Bariatric Surgery Patient. In: Schauer, P.R., Schirmer, B.D., Brethauer, S.A. (eds) Minimally Invasive Bariatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-0-387-68062-0_59

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  • DOI: https://doi.org/10.1007/978-0-387-68062-0_59

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-68058-3

  • Online ISBN: 978-0-387-68062-0

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