Influence of jejunoileal bypass on protein metabolism during pregnancy

Management of the pregnant patient who has undergone operation for jejunoileal bypass poses many problems for the attending obstetrician. Several recent studies have broadened our knowledge of this group of patients. Unfortunately, the significance of this form of weight loss upon the developing fetus is at best only poorly understood. In our study, amino acid chromatography was performed at 34 weeks' gestation and at delivery in order to assess the impact of this procedure upon maternal and fetal (cord blood) amino acid concentrations. Results suggest that protein metabolism in the patient who has had intestinal bypass without resulting complications and in her fetus is comparable to that in normal pregnancy. Altered amino acid profiles were observed in one twin gestation and in one patient who continued to lose weight throughout pregnancy. The significance of these observations is discussed with respect to the relationship of protein deprivation to neonatal development.