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Objectives: The rate of morbid obesity among women of reproductive age continues to rise worldwide. Surgical treatment remains the most effective mean to face it. Anatomical, physiological and nutritional modifications lead to several challenges for pregnancy after bariatric procedures. In spite of routine supplementation after bariatric surgery, vitamin and mineral deficiency frequently appear in bariatric pregnancies. The aim of this review is to summarize the existing data on the prevalence and management of nutritional deficiencies in pregnancy after bariatric surgery. Methodology:A comprehensive search of Pubmed Database was conducted for English-language studies using a list of key words. Results:The most common post-operative deficiencies in pregnancy include iron, vitamin B12, folate, vitamin D and magnesium deficiency. Less common are selenium, vitamin A, vitamin B6 and vitamin C deficiency. Finally, copper, vitamin K, vitamin B1, vitamin E and albumin deficiencies are considered to be relatively rare.Conclusions: Pregnancy after bariatric surgery has been proven to be safe for both the mother and the fetus.However, there is still the risk of significant nutritional deficiencies with adverse effects on pregnancy and lactation.As a result, a thorough customized nutritional assessment is mandatory for every woman in reproductive age who has undergone a bariatric operation, with strict regular follow-up during pregnancy and lactation.

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Funding Acknowledgements Type of funding sources: None. Background Intra-aortic balloon pump (IABP) can be used as circulatory support in order to stabilize haemodynamically compromised patients as either a bridge to therapy or to further mechanical support. Based on the current literature its use should be limited to up to two weeks and there are not enough data regarding its long term use’s efficacy and possible complications. Purpose To review the possible complications of the long-term use of IABP Methods We restrospectively analysed the data from 24 consecutive patients with end-stage heart failure (ESHF) who received long-term IABP support and recorded the complications during their hospitalization as well as their outcome. Results 24 patients (14 male and 10 female) were included. In 5 of them ESHF was attributed to ischemic cardiomyopathy and the in 19 to dilated cardiomyopathy. Their mean age was 45.6+/-14 years. The mean duration of IABP support was 70.2 days (minimum 30days maximum 192 days). The mean ejection fraction (EF) was 20%. Regarding the pharmacological therapy, 12/24 patients were on dobutamine, 4/24 on dobutamine and milrinone and 8/24 on dobutamine and noradrenaline. Regarding the clinical course of these patients, 7/24 underwent heart transplantation, 2/24 managed to wean from IABP, 5/24 received left lentrivular assist device (LVAD), 6/24 received biventricular assist veice (BiVAD) and 4/24 died. In terms of complications they were recorded as following : infection 7/24, bleeding 3/24, thrombosis 4/24, heparin-induced thrombocytopenia(HIT) 5/24, hematoma 4/24, ischemia 0/24 and rupture 1/24. Conclusions   Although not indicated by the current guidelines, long term IABP can be used as a relatively safe  circulatory support method.

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