15 Aralık 2009 Salı

Evaluation of the Pregnancy and Birth Outcomes after Gastric Banding Surgery

Prevalence of the obesity that has been increased at recent years present the gynaecologists with obese pregnant women’s problems. At the women’s pregnancy period, obesity causes to increasing of some risks both for the mother and the baby will new born. The most important birth problems for the mother are premature birth risk, increased problems at the moment of birth, hypertension induced by pregnancy and preeclampsia, pregnancy diabetes and excess weight gaining during the pregnancy. On the other side intrauterin growth retardation, macrosomia and fetal growth anomalies are more frequently encountered for the baby.

Here, I will try to examine the outcomes of gastric banding (staple) surgery which we have encountered as a frequently used method at obesity treatment, on pregnant obese women.

Bar-Zohar et al. (Pregnancy after laparoscopic adjustable gastric banding: perinatal outcome is favorable also for women with relatively high gastational weight gain. Surg Endosc. 2006;20:1580-3) have evaluated 74 women those have become pregnant after gastric banding surgery and defined mean gained weight as 10.6±2.1 kg in their study. All births have realized after the 39th week and mean birth weight has been identified as 3.09±0.5 kg. Major congenital anomaly at women, post-natal hypoglycemia at babies, baby death during or after the birth have not seen. In the light of these findings the authors those have performed this study, have been stated that; pregnancy and birth after gastric banding surgery are considerable confidential both for the mother and the baby.

John D. Dixon et al. (Birth outcomes in obese women after laparoscopic adjustable gastric banding. Obstet Gynecol 2005;106:965-72) have indicated that pregnancy and birth outcomes of the women those have underwent gastric banding surgery are in compliance with values of the women those have become pregant with normal weight and as a result they have pointed out the reliability of this method on pregnant obese women. Adjustability of the staple is an important feature, because this provides the ability for adaptation of the surgery procedure as per pregnancy requirements. A multidisciplinary approach included collective collaboration of obesity surgeon and gynaecologist has been suggested after such applications.

Vejux N et al. (Pregnancy after gastric banding: maternal tolerance, obstetrical and neonatal outcomes. Gynecol Obstet Fertil 2007;35:1143-7) have made evaluation by studying on 7 papers concerning this issue. With regard to obtained data they have ben stated that gastric banding surgery is quite tolerated during the pregnancy and it could be suggested to the obese women in the age of birth child.

The studies mentioned above have showed the pregnancy problems depends on obesity may result in quite high danger. The weight loss after gastric banding which has been commonly used at recent years decrease these risks. The women those have underwent gastric banding operation and then become pregnant can complete their pregnancy process in a successful way without removed their staples and in company with the regular controls.

Assoc. Prof. Halil Coskun M.D.