Pregnancy outcome following bariatric surgery Flashcards
What proportion of women who die in pregnancy are overweight/obese
50%
Prevalence of obesity in reproductive age
28%
Risks of obesity in pregnancy
Spont abortion
Gestational DM
HTN
EMCS
VTE
Wound infection
PPH
Congenital anomalies
Macrosomia
Shoulder dystocia
Admission neonatal unit
Stillbirth
When is biatric surgery offered
BMI >40 and lifestyle/,medications ineffective
What proportion of bariatric surgery are women childbearing age
50^
3 main type og biatric surgery
Restrictive (reduce caloric intake by reduce gastric capacity)
Malabsorptive
Mixture
Most common type procedures
Laparoscopic adjustable gastric banding (restrictive)
Roux-en-Y bypass (mixed)
Complications rates of procedures
5%
Consequents of gastric band
Band adjustment used to regulate weight gain
Complications - gastric prolapse, Somali obstruction, puch dilatation, gastric erosion, necrosis
What is a sleeve gastrectomy?
Irreversible
Involves removing most of stomach leaving sleeve shaped cylinder of stomach with reduced capacity
Which procedure has most extreme malabsorption
Biliopancreastic diversion
Malasorbative - low iron calcium, folate, thiamine, B12 and fat solum vitamins deficiency
Which surgery has highest risk of mortality
Jejunoileal bypass
Hepatic and renal failure
Complication of Roux-en-Y gastric bypass (RYGB)
Dumping syndrome experience by ingestion large quantities of carbohydrate
Coms stomal stenosis, ices, intestinal hernia, nutrient deficiency
How long to wait after weight loss surgery before pregnancy
1 year - rapid weight loss, nutritional deficiency
Pregnancy associations if < 1 year between surgery and pregnancy
Preterm delivery
?Miscarriage
No difference IUGR< CS, PIH or GDM
