{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T13:16:59Z","timestamp":1780579019453,"version":"3.54.1"},"reference-count":52,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T00:00:00Z","timestamp":1675209600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Bariatric surgery is a successful treatment for sustainable weight loss and has been associated with improvement in cardiovascular function. Pregnancy after bariatric surgery is becoming increasingly common; however, little is known about the maternal cardiovascular system postsurgery. The aim of this study was to investigate maternal cardiovascular adaptation to pregnancy in women with previous bariatric surgery, compared with that in women with no history of weight\u2010loss surgery and an early\u2010pregnancy body mass index (BMI) similar to the presurgery BMI of the postbariatric women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective, observational, longitudinal study conducted from April 2018 to June 2020 including 30 pregnant women who had undergone bariatric surgery and 30 who had not, matched for presurgery BMI. Participants were seen at three timepoints during pregnancy: 12\u201314, 20\u201324 and 30\u201332\u2009weeks' gestation. At all visits, maternal blood pressure (BP) was measured and cardiac geometry and function were assessed using two\u2010dimensional (2D) transthoracic echocardiography. On a subset of patients (15 in each group), 2D speckle tracking was performed to assess global longitudinal and circumferential strain. Offline analysis was performed, and multilevel linear mixed\u2010effects models were used for all comparisons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared with the no\u2010surgery group, and across all trimesters, pregnant women with previous bariatric surgery had lower BP, heart rate and cardiac output and higher peripheral vascular resistance (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01 for all). Similarly, the postbariatric group demonstrated more favorable cardiac geometry and diastolic indices, including lower left ventricular mass, left atrial volume and relative wall thickness, together with higher E\u2010wave\/A\u2010wave flow velocity across the mitral valve and higher mitral velocity (E\u2032) at the lateral and medial annulus on tissue Doppler imaging (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01 for all). There was no difference in ejection fraction, although global longitudinal strain was lower in postbariatric women (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01), indicating better systolic function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings indicate better maternal cardiovascular adaptation in women with previous bariatric surgery compared with presurgery BMI\u2010matched pregnant women with no history of weight\u2010loss surgery. \u00a9 2022 The Authors. <jats:italic>Ultrasound in Obstetrics &amp; Gynecology<\/jats:italic> published by John Wiley &amp; Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.26042","type":"journal-article","created":{"date-parts":[[2022,8,4]],"date-time":"2022-08-04T06:58:52Z","timestamp":1659596332000},"page":"207-214","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of bariatric surgery on maternal cardiovascular system"],"prefix":"10.1002","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4086-0107","authenticated-orcid":false,"given":"D.","family":"Patel","sequence":"first","affiliation":[{"name":"Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, Department of Metabolism Digestion and Reproduction, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Borrelli","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8008-5144","authenticated-orcid":false,"given":"O.","family":"Patey","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, Department of Metabolism Digestion and Reproduction, Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Di Salvo","sequence":"additional","affiliation":[{"name":"Royal Brompton Hospital, Royal Brompton and Harefield NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0125-2299","authenticated-orcid":false,"given":"M. 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