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Pregnancy after bariatric surgery: screening for gestational diabetes

BMJ 2017; 356 doi: (Published 03 February 2017) Cite this as: BMJ 2017;356:j533
  1. Safwaan Adam, clinical research associate1 2 3,
  2. Basil Ammori, honorary professor of surgery1 2,
  3. Handrean Soran, consultant physician and endocrinologist1 3,
  4. Akheel A Syed, honorary senior lecturer1 2
  1. 1Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK 2Salford Royal NHS Foundation Trust, Salford, UK
  2. 3University Department of Medicine, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
  1. Correspondence to: S Adam s.adam{at}

Safer alternatives are needed to traditional test

Obesity affects a quarter of adult women in the UK, western Europe, and Canada, and a third in the US. More women than men have bariatric surgery every year,1 and most are of childbearing age. Of 12 869 women in the UK who had primary bariatric surgery in 2011-13, 8469 (66%) were younger than 50.1 Furthermore, fertility in obese women generally improves after bariatric surgery as menstrual irregularity and ovulatory problems resolve with weight loss.23 Thus, increasing numbers of women with obesity start or complete their families after bariatric surgery.

Despite weight loss after surgery, many women still require screening for gestational diabetes mellitus during pregnancy. A history of bariatric surgery has important implications for the choice of test since an oral glucose tolerance test can trigger dumping syndromes, with serious adverse effects.

The two most common primary bariatric procedures, Roux-en-Y gastric bypass (54%) and sleeve gastrectomy (20%),1 can both cause …

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