Impact of Laparoscopic Adjustable Gastric Banding on Pregnancy, Maternal Weight, and Neonatal Health

Carelli, Allison M.; Ren, Christine; Youn, Heekoung; Friedman, Erica B.; Finger, Anne E.; Lok, Benjamin H.; Kurian, Marina; Fielding, George

doi:10.1007/s11695-010-0265-1

Cited by 39 publications

(18 citation statements)

References 18 publications

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“…There were no cases of low birth weight or congenital abnormalities reported 2. The percentage of gastric band slippage during pregnancy is also consistent with that of Skull et al 3 who reported gastric band slippage in 2 of 49 patients and of Carelli et al 4 who showed slippage in 3.2% of pregnancies.…”

Section: Discussionsupporting

confidence: 83%

Pregnancy as a risk factor for undertreatment after bariatric surgery

Jacquemyn¹,

Meesters

2014

BMJ Case Reports

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SUMMARYA pregnant woman presented at the emergency department with severe nausea and vomiting at 20 weeks of gestational age; she was known with gastric banding. Advanced imaging studies were avoided of fear to harm the fetus. The patient continued to vomit and at 23 weeks intrauterine fetal death was noted. The symptoms did not resolve after delivery and CT scan demonstrated slippage of the gastric band over the pylorus resulting in a high digestive obstruction as the cause of hyperemesis and finally resulting necrosis of the vasa brevia. The gastric band was laparoscopically removed along with the necrotic tissue. Avoidance of radiological and endoscopic investigations of fear to harm the pregnancy resulted in complications and possibly in fetal death. BACKGROUND

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Section: Discussionsupporting

confidence: 83%

Pregnancy as a risk factor for undertreatment after bariatric surgery

Jacquemyn¹,

Meesters

2014

BMJ Case Reports

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“…Keywords searched were: "bariatric surgery and reproduction". Forty articles were identified, but fifteen articles were reviews [67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82] , sixteen articles were on pregnancy outcomes after bariatric surgery [83][84][85][86][87][88][89][90][91][92][93][94][95][96][97][98] , three were commentaries or author replies [99][100][101] , two investigated contraceptive use post-bariatric surgery 102,103 , one was a cross-sectional assessment of reproductive health in women undergoing bariatric surgery 104 , one was a case report of empty follicle syndrome in a woman post-bariatric surgery undergoing IVF 105 , and one article was a case series of IVF in women who had previously undergone bariatric surgery 106 . In these last two articles, special considerations were outlined for IVF in women with previous bariatric surgery 106 .…”

Section: Weight Loss Through Bariatric Surgerymentioning

confidence: 99%

Obesity and reproductive function

Klenov¹,

Jungheim²

2014

Current Opinion in Obstetrics &Amp; Gynecology

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SYNOPSISObesity is associated with multiple adverse reproductive outcomes, but the mechanisms involved are largely unknown. Public health scientists studying obesity and its effects on health outcomes have referred to obesity as a "complex system", defined as a system of heterogeneous parts interacting in nonlinear ways to influence the behavior of the parts as a whole 1,22 . By this definition, human reproduction is also a complex system which may explain some of the difficulty in identifying the mechanisms linking obesity and adverse reproductive function. Despite the difficulties, research on obesity and reproduction is important as there is an epidemic of obesity among reproductive age women with associated consequences for future generations. In this review we discuss the adverse reproductive outcomes associated with obesity and data from translational studies of the mechanisms involved. We conclude with a brief discussion of public health policy as it relates to the treatment of infertility in obese women. Keywords fertility; obesity; reproduction; public health MEASURING OBESITY AND REPRODUCTIVE RISKDisentangling the individual components of obesity associated with poor health outcomes is difficult. Body mass index (BMI) or overall body size adjusted for height, is obviously, the most accessible measure of obesity as the tools for measuring BMI are readily available. On the other hand, adiposity (regional or total body fat), adipokine production, and lifestyle components may also contribute individually or together to overall obesity-related health risk. The bulk of the work relating obesity to health risks has focused on chronic diseases, however, we are learning more about components of obesity that relate to reproductive risk.

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“…In particular for LAGB, data on pregnancy outcomes are limited [3]. In a subanalysis of a systematic review by Galazis et al, LAGB did not appear to increase the risk of IUGR as was seen in other bariatric surgery procedures [14].…”

Section: Literaturementioning

confidence: 98%

“…In 2014, 39% of adults aged 18 years and older were overweight, and 13% were obese. Overall, pregnant obese women are at higher risk of obstetrical complications [2][3][4][5]. There is a significant increased risk of namely fertility problems, miscarriage, gestational diabetes, gestational hypertension, preeclampsia, macrosomia, caesarean section and its related complications such as haemorrhage, wound infection and anaesthetic complications.…”

Section: Literaturementioning

confidence: 99%

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Unusual bariatric complication in pregnancy

Wessel¹,

Nieuwenhove²

2016

European Journal of Obstetrics & Gynecology and Reproductiv

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A 21-year old woman, G1P0, was admitted to our University Hospital at 33 weeks and 2 days of gestational age with a 1 week history of nausea and vomiting and doubled transaminases. Two years before she underwent laparoscopic adjusted gastric banding (LAGB). The estimated fetal weight was 1960 grams (corresponding with P25), doppler measurements were all normal. There was an anhydramnion. Because of gestational age, betamethasone 12 mg was administered twice intramuscularly, with an interval of 24 hours. Because of clinical and biochemical deterioration a primary cesarean section was performed based on the suspicion of a HELLP syndrome. Subsequent to the caesarean section, the epigastric pain, nausea and vomiting persisted.An esophagogastroduodenoscopy (EGD) was performed and showed serious band slipping. The patient was planned for urgent laparoscopy. At laparoscopy, a gigantic edematous stomach was seen (size comparable to a 40 weeks gravid uterus), as well as ascites. At exploration, not only a slipping of the gastric band was seen, but also a torsion of the stomach. The postoperative phase was uneventful. One month later, the patient was seen in the outpatient clinic without digestive symptoms.

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Impact of Laparoscopic Adjustable Gastric Banding on Pregnancy, Maternal Weight, and Neonatal Health

Abstract: LAGB is tolerable in pregnancy with rare intrapartum band slips. Weight gain is less in those with higher pre-pregnancy BMI and those who had their bands filled or not adjusted. Babies born to these mothers are as healthy as the general population.

Cited by 39 publications

References 18 publications

Pregnancy as a risk factor for undertreatment after bariatric surgery

Pregnancy as a risk factor for undertreatment after bariatric surgery

Obesity and reproductive function

Unusual bariatric complication in pregnancy

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