Bariatrik Cerrahi Sonrası Gebelik Yönetimi
Özet
Bariatrik cerrahi (BC), obezite tedavisinde etkin ve giderek daha sık uygulanan bir yöntemdir. Fertil çağdaki kadınlarda hem obezitenin komplikasyonlarını azaltması hem de fertiliteyi artırması açısından önemli avantajlar sunmaktadır. Bununla birlikte, BC sonrası gebelikler maternal ve fetal açıdan özel riskler taşır. Gestasyonel diyabet ve preeklampsi gibi obeziteye bağlı komplikasyonları azaltırken, fetal gelişme geriliği (FGR), küçük gebelik yaşına göre bebek (SGA) ve preterm doğum gibi riskleri artırabilir. Bu nedenle postbariatrik gebeliklerde beslenme desteği, mikronutrient replasmanı, fetal büyümenin düzenli izlenmesi ve multidisipliner takip kritik öneme sahiptir. Ayrıca, cerrahi tipine özgü komplikasyonların (ör. internal herniasyon, bant kayması) farkında olunması maternal ve perinatal mortaliteyi azaltır. BC sonrası gebelik yönetimi kişiselleştirilmiş ve kanıta dayalı bir yaklaşım gerektirir.
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