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Pregnancy and bariatric surgery

Vasileios Charalampakis, Abd A Tahrani, Ahmed Helmy, Janesh K Gupta, Rishi Singhal
One of the most effective methods to tackle obesity and its related comorbidities is bariatric surgery. Polycystic ovary syndrome (PCOS) and endometrial hyperplasia (EH), which are associated with increased risk of endometrial carcinoma, have been identified as potentially new indications for bariatric surgery. PCOS is the most common endocrine disorder in women in the reproductive age and is associated with several components of the metabolic syndrome such as obesity, insulin resistance and hypertension. EH is a pre-cancerous condition which arises in the presence of chronic exposure to estrogen unopposed by progesterone such as both in PCOS and obesity...
October 17, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Radwan Kassir, Marie-Pierre Goiset, Nicolas Williet, Olivier Tiffet
No abstract text is available yet for this article.
October 20, 2016: International Journal of Surgery
Michael Feichtinger, Tina Stopp, Sandra Hofmann, Stephanie Springer, Sophie Pils, Alexandra Kautzky-Willer, Herbert Kiss, Wolfgang Eppel, Andrea Tura, Latife Bozkurt, Christian S Göbl
AIMS/HYPOTHESIS: A history of gastric bypass surgery can influence the results of the OGTT recommended during pregnancy. Therefore, we compared OGTT glucose kinetics and pregnancy outcome between pregnant gastric bypass patients and BMI-matched, lean and obese controls. METHODS: Medical records were used to collect data on glucose measurements during the 2 h 75 g OGTT as well as on pregnancy and fetal outcome for 304 women (n = 76 per group, matched for age and date of delivery)...
October 18, 2016: Diabetologia
Lucyna Ostrowska, Medard Lech, Ewa Stefańska, Marta Jastrzębska-Mierzyńska, Joanna Smarkusz
Obesity in women of reproductive age is a serious concern regarding reproductive health. In many cases of infertility in obese women, reduction of body weight may lead to spontaneous pregnancy, without the need for more specific methods of treatment. Bariatric surgery is safe and is the most effective method for body weight reduction in obese and very obese patients. In practice there are two bariatric techniques; gastric banding, which leads to weight loss through intake restriction, and gastric bypass, leads to weight loss through food malabsorption...
2016: Ginekologia Polska
Françoise Schmitt, Philippe Topart, Agnès Salle, Loïc Sentilhes, Natacha Bouhours-Nouet, Régis Coutant, Dominique Weil, Guillaume Podevin
We report here a case of a rarely described complication of laparoscopic adjustable gastric banding (LAGB), slippage during the postpartum period, after LAGB had been performed in an adolescent obese girl. The LAGB had been placed after one year of clinical survey initiated at the age of 16. Maximal pre-operative body mass index (BMI) was 48.5 kg.m(-2) and obesity was associated with insulin resistance. Before pregnancy, there was a loss of 17 Kg (final BMI = 41.5 kg.m(-2)) and a resolution of insulin resistance...
2016: Journal of Surgical Case Reports
Helmut Kleinwechter, Norbert Demandt
In Germany in 5.5% of all births diabetes is registered. In patients with type 1 and type 2 diabetes planning pregnancy, preconception counseling, diabetologic care with optimized periconceptional metabolic control and folic acid supplementation are essential for good pregnancy outcome. Gestational diabetes (GDM) should be diagnosed timely and managed according to existing guidelines. GDM is treated with insulin in approximately 20%. In 1-2% of GDM cases a glucokinase gene mutation is present (MODY 2). Pregnancies after bariatric-metabolic surgery are increasing and show high risks...
September 2016: Deutsche Medizinische Wochenschrift
Christel A L de Raaff, Wietse J Eshuis, Bart A van Wagensveld, Ruben N van Veen
Women desiring pregnancy might fail to conceive due to their obesity. Bariatric surgery has shown to reduce this infertility up to 58% and is therefore considered a successful strategy for morbidly obese infertile women. Nevertheless, when pregnancy has succeeded, surgery-related complications might occur.Banded laparoscopic Roux-en-Y gastric bypass (B-LRYGB) is a relatively new technique in which a band is placed around the small gastric pouch. We report a case of a 30-year-old woman who succeeded to become pregnant after weight loss due to B-LRYGB, but presented with acute abdominal pain in Week 33 of her pregnancy...
2016: Journal of Surgical Case Reports
Poupak Fallahi, Silvia Martina Ferrari, Ilaria Ruffilli, Francesca Ragusa, Marco Biricotti, Gabriele Materazzi, Paolo Miccoli, Alessandro Antonelli
INTRODUCTION: The most recent advance concerning levothyroxine (L-T4) therapy is the development of novel oral formulations: the liquid preparation, and the soft gel capsule. AREAS COVERED: This review evaluates the most recent clinical studies about these new formulations. The liquid formulation has been shown to overcome: the food and beverages intereference with L-T4 tablets absorption, caused by food or coffee at breakfast; malabsorption induced by the increased gastric pH, resulting from atrophic gastritis, or due to proton-pump inhibitors; and malabsorption after bariatric surgery...
August 23, 2016: Expert Opinion on Drug Delivery
Audrey Binette, Kerry Howatt, Ashley Waddington, Robert L Reid
Despite the introduction of promising products into the contraceptive market, the rate of unintended pregnancies remains high. Women with underlying medical conditions should have access to safe and effective contraceptive methods for various reasons, including the potential deleterious effect of the disease on the pregnancy or the effect of the pregnancy on the disease process. Healthcare providers are often confronted with cases in which contraception counseling is problematic due to controversial evidence and persistent myths...
August 22, 2016: Journal of Women's Health
Marcio C Mancini
No abstract text is available yet for this article.
August 2016: Archives of Endocrinology and Metabolism
G Craig Wood, Peter N Benotti, Clare J Lee, Tooraj Mirshahi, Christopher D Still, Glenn S Gerhard, Michelle R Lent
Importance: Weight loss after bariatric surgery varies, yet preoperative clinical factors associated with long-term suboptimal outcomes are not well understood. Objective: To evaluate the association between preoperative clinical factors and long-term weight loss after Roux-en-Y gastric bypass (RYGB). Design, Setting, and Participants: From June 2001 to September 2007, this retrospective cohort study followed up RYGB patients before surgery to 7 to 12 years after surgery...
August 10, 2016: JAMA Surgery
Adam H Balen, Lara C Morley, Marie Misso, Stephen Franks, Richard S Legro, Chandrika N Wijeyaratne, Elisabet Stener-Victorin, Bart C J M Fauser, Robert J Norman, Helena Teede
BACKGROUND: Here we describe the consensus guideline methodology, summarise the evidence-based recommendations we provided to the World Health Organisation (WHO) for their consideration in the development of global guidance and present a narrative review on the management of anovulatory infertility in women with polycystic ovary syndrome (PCOS). OBJECTIVE AND RATIONALE: The aim of this paper was to present an evidence base for the management of anovulatory PCOS...
August 10, 2016: Human Reproduction Update
Ram Prakash Narayanan, Akheel A Syed
Bariatric surgery is most commonly carried out in women of childbearing age. Whilst fertility rates are improved, pregnancy following bariatric surgery poses several challenges. Whilst rates of many adverse maternal and foetal outcomes in obese women are reduced after bariatric surgery, pregnancy is best avoided for 12-24 months to reduce the potential risk of intrauterine growth retardation. Dumping syndromes are common after bariatric surgery and can present diagnostic and therapeutic challenges in pregnancy...
October 2016: Obesity Surgery
Goele Jans, Christophe Matthys, Sarah Bel, Lieveke Ameye, Matthias Lannoo, Bart Van der Schueren, Bruno Dillemans, Luc Lemmens, Jean-Pierre Saey, Yves van Nieuwenhove, Pascale Grandjean, Ben De Becker, Hilde Logghe, Marc Coppens, Kristien Roelens, Anne Loccufier, Johan Verhaeghe, Roland Devlieger
BACKGROUND: The expansion of the obesity epidemic is accompanied with an increase in bariatric procedures, in particular in women of reproductive age. The weight loss induced by the surgery is believed to reverse the negative impact of overweight and obesity on female reproduction, however, research is limited to in particular retrospective cohort studies and a growing number of small case-series and case-(control) studies. METHODS/DESIGN: AURORA is a multicenter prospective cohort study...
2016: BMC Pregnancy and Childbirth
Kamal K Mahawar, Yitka Graham, Peter K Small
No abstract text is available yet for this article.
June 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Eric Edison, Martin Whyte, Jeremy van Vlymen, Simon Jones, Piers Gatenby, Simon de Lusignan, Jill Shawe
BACKGROUND: The aims of this study are the following: to describe the female population of reproductive age having bariatric surgery in the UK, to assess the age and ethnicity of women accessing surgery, and to assess the effect of bariatric surgery on factors that underlie fertility and pregnancy outcomes. METHODS: Demographic details, comorbidities, and operative type of women aged 18-45 years were extracted from the National Bariatric Surgery Registry (NBSR)...
June 18, 2016: Obesity Surgery
Yvonne Linicus, Ingrid Kindermann, Bodo Cremers, Christoph Maack, Stephan Schirmer, Michael Böhm
OBJECTIVE: Obesity is a risk factor for cardiovascular disease and venous thrombosis. Previous studies have shown that in late pregnancy a compression of the inferior vena cava (VCI) leads to a hypotensive syndrome. The objective of this study was to explore the correlation between obesity and an elevated pressure in the VCI simulating obesity-induced vena cava compression syndrome. METHODS: A left and right heart catheterization was performed in 29 patients. After right atrial pressure measurement, the catheter was pulled back through the VCI, and the pressure gradient between the thoracic and abdominal vena cava was measured...
August 2016: Obesity
Nevert Badreldin, Jeffrey Kuller, Eleanor Rhee, Laura Brown, Steven Laifer
Obesity is a source of major morbidity and mortality and is a growing concern worldwide. Maternal obesity is associated with increased maternal and fetal risks during pregnancy. Bariatric surgery has emerged as one of the most sustainable treatments for severe obesity and its comorbidities. Patients who have undergone bariatric surgery often experience drastic improvements in hypertension and diabetes. It is not surprising, therefore, that the incidence of bariatric surgery is increasing, particularly in women of childbearing age...
June 2016: Obstetrical & Gynecological Survey
Mariella Silva de Oliveira-Costa, Anne Caroline Coelho Leal Árias Amorim, Aede Gomes Cadaxa, Ana Valéria Machado Mendonça
The study identifies the discourse and opinions about women's health in relation to their eating habits by means of qualitative research using the journalistic discourse analysis method of the Folha de São Paulo newspaper. Based on the selection of texts on health, women's health and nutrition published throughout the year 2013, the sample resulted in seven journalistic texts, in which voices from the scientific universe related to research, quotes from journals, scientific associations and the opinion of health professionals and researchers were predominantly identified...
June 2016: Ciência & Saúde Coletiva
Lucie Favre, Muriel Clarisse, François P Pralong, Michel Suter, Pierre Fournier, David Baud
Bariatric surgery interventions are rapidly growing and most are performed on female patients. Thus, pregnancies after bariatric surgery are increasingly common. Awareness of the consequences and risks of bariatric surgery on subsequent pregnancies is important. Literature data report a reduction of the usual pregnancy risks of pregnancies in obese patients, but also an increased risk of small-for-gestational-age infants, possibly related to nutritional deficiencies. A careful screening for micronutrient deficiencies is therefore already advised before conception...
March 23, 2016: Revue Médicale Suisse
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