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      Internal Herniation in Pregnancy After Gastric Bypass : A Systematic Review

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          Abstract

          To assess maternal and fetal outcomes of pregnancies complicated by internal herniation after Roux-en-Y gastric bypass.

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          Outcomes of pregnancy after bariatric surgery.

          Kari Johansson, Sven Cnattingius, Ingmar Näslund … (2015)
          Maternal obesity is associated with increased risks of gestational diabetes, large-for-gestational-age infants, preterm birth, congenital malformations, and stillbirth. The risks of these outcomes among women who have undergone bariatric surgery are unclear.
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            Reproductive outcome after bariatric surgery: a critical review.

            Isabelle Guelinckx, Roland Devlieger, Greet Vansant (2015)
            After many cycles of weight loss and weight gain, more and more morbidly obese patients undergo bariatric surgery, like gastric banding or gastric bypass, as the ultimate treatment for their obesity-problem. Since women of reproductive age are candidates for bariatric surgery, concerns arise regarding the potential impact on future pregnancy. English-language articles were identified in a PUBMED search from 1982 to January 2008 using the keywords for pregnancy and bariatric surgery or gastric bypass or gastric banding. The few reported case-control and cohort studies clearly show improved fertility and a reduced risk in obstetrical complications, including gestational diabetes, macrosomia and hypertensive disorders of pregnancy, in women after operatively induced weight loss when compared with morbidly obesity women. The incidence of intrauterine growth restriction (IUGR) appears to be increased, however. No conclusions can be drawn concerning the risk for preterm labour and miscarriage, although these risks are probably increased compared with controls matched for body mass index. Operative complications are not uncommon with bariatric surgery and several cases have pointed to the increased risk for intestinal hernias and nutritional deficiencies in subsequent pregnancy. Deficiencies in iron, vitamin A, vitamin B(12), vitamin K, folate and calcium can result in both maternal complications, such as severe anaemia, and fetal complications, such as congenital abnormalities, IUGR and failure to thrive. Close supervision before, during and after pregnancy following bariatric surgery and nutrient supplementation adapted to the patient's individual requirements can help to prevent nutrition-related complications and improve maternal and fetal health, in this high-risk obstetric population.
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              Small bowel obstruction in pregnancy is a complex surgical problem with a high risk of fetal loss.

              PJ Webster, MA Bailey, J. Wilson … (2015)
              Small bowel obstruction (SBO) in pregnancy is rare and is most commonly caused by adhesions from previous abdominal surgery. Previous literature reviews have emphasised the need for prompt laparotomy in all cases of SBO because of the significant risks of fetal loss and maternal mortality. We undertook a review of the contemporary literature to determine the optimum management strategy for SBO in pregnancy.
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                Author and article information

                Journal
                Title: Obstetrics & Gynecology
                Abbreviated Title: Obstetrics & Gynecology
                Publisher: Ovid Technologies (Wolters Kluwer Health)
                ISSN (Print): 0029-7844
                Publication date Created: 2016
                Publication date (Print): June 2016
                Volume: 127
                Issue: 6
                Pages: 1013-1020
                Article
                DOI: 10.1097/AOG.0000000000001429
                PubMed ID: 27159745
                SO-VID: e5eb7473-8e22-4646-92df-e62515661f71
                Copyright © © 2016
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