[Pregnancy after bariatric surgery]

PREGNANCY AFTER BARIATRIC SURGERY Pregnancy after bariatric surgery is a high-risk pregnan¬cy that requires multidisciplinary management. Although maternal pathologies (gestational diabetes and gravid hypertension) and the risk of macrosomia are greatly reduced, the risk of prematurity and small for gestatio¬nal age is increased. Nutritional needs are specific, and require adapting supplements and reinforcing biological monitoring during pregnancy and lactation, taking into account the specificities of interpretation of biological results in this context. Surgical complications are rare (displacement of the gastric band, occlusion due to internal hernia after Roux-en-Y gastric bypass) but must be systematically evoked in the presence of vomiting or abdominal pain because the maternal-fetal prognosis depends on the rapidity of surgical management. A postoperative conception delay of at least 12 months should be respected and effective contraception pres¬cribed in this perspective. Long-term cohort studies are necessary to better understand the long-term outcomes for children.