Immediate return of fertility function following a bariatric surgery: A case report.

Obesity in women of childbearing age is linked to lower fertility rates due to chronic oligoovulation and anovulation. Effective weight loss treatment such as bariatric surgery can improve fertility potential. However, pregnancy during the first 12 months after bariatric surgery should be avoided due to an active catabolic state and may increase the potential risk of fetal growth restriction. Here, we report a case with an immediate return of fertility function following a bariatric surgery with favorable outcomes. A 30-year-old woman with obesity, history of polycystic ovarian syndrome and infertility become pregnant within 2-month period following bariatric surgery. She first recognized her pregnancy at the gestational age of 8 weeks. Micronutrient laboratory results at baseline were normal except for low 25-OH vitamin D level of 18.7 ng/dL. She continued to lose her weight during the first trimester but was able to gain some weight during the second and third trimesters. Close fetal ultrasonography monitoring was done during each trimester. The fetal ultrasonography showed an appropriate fetal weight, a normal Doppler study and no abnormality detected in the fetus. Finally, at 36 weeks of gestation, a 2380-g female baby was delivered successfully.

Magnesium sulfate maintenance infusion in women with preeclampsia: a randomized comparison between 2 gram per hour and 1 gram per hour.

OBJECTIVE: To compare the percentages of pregnant women with preeclampsia who reached the therapeutic serum magnesium levels between those who received maintenance magnesium sulfate infusion of 2 g/hour versus I g/hour MATERIAL AND METHOD: Sixty women diagnosed of preeclampsia and magnesium sulfate that were considered for seizure prophylaxis were randomized into two groups. A loading dose of 5 g magnesium sulfate was given intravenously over 20 minutes to both groups. Maintenance doses of magnesium sulfate of 2 g/hour and 1 g/hour were given to the study and control groups, respectively. The maintenance dose was continued until 24 hours postpartum. Blood samples for serum magnesium were collected at 0, 1/2, 2, and 4 hours after the loading dose and at 2 and 12 hours after delivery. Clinical signs of magnesium toxicity were carefully monitored. Maternal and neonatal outcome were evaluated. RESULTS: Significantly more women in the present study group reached the therapeutic level of serum magnesium at 2 hours (70% vs. 23%, p = 0.001) and at 4 hours (80% vs. 17%, p = 0.00) after the loading dose and at 2 hours (60% vs. 20%, p = 0.003) and at 12 hours (80% vs. 37%, p = 0.001) after delivery. No clinical magnesium toxicity was observed There were no significant differences in maternal and neonatal outcomes between the two groups. CONCLUSION: The maintenance dose of magnesium sulfate at 2 g/hour was more likely to attain the therapeutic level of serum magnesium when compared to 1 g/hour with no detectable difference in maternal and neonatal outcomes.