ThinnerTimes

Home Weight Loss Surgery Lap-Band® Lap-Band Expectations - Pregnancy
Lap-Band Expectations - Pregnancy PDF Print E-mail
Article Index
Lap-Band Expectations
Weight Loss
Pregnancy
Relief of Comorbid Conditions
All Pages

Pregnancy appears to go well for mother and baby with the weight loss that follow Lap-Band placement. Benefits include:

  • Less maternal gestational diabetes
  • Less maternal hypertension
  • Lap-Band can be adjusted as necessary
  • No increase in fetal complications

Here are the summaries of recent articles in the medical literature:

Pregnancy after laparoscopic adjustable gastric banding: perinatal outcome is favorable also for women with relatively high gestational weight gain.

Bar-Zohar D, Azem F, Klausner J, Abu-Abeid S.

Department of Surgery B, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, 6 Weizmann Street, Tel-Aviv, 64239, Israel.

BACKGROUND: The prevalence of morbid obesity is increasing steadily among women of reproductive age. In addition to the well-known comorbidities of the disease, it has been shown that the pregnancy outcome for obese women is worse than for women with a normal body mass index. This study aimed to evaluate the pregnancy and perinatal outcomes for women who underwent laparoscopic adjustable gastric banding (LAGB) because of morbid obesity. METHODS: This prospective, population-based study was conducted in a general surgery clinic of a tertiary hospital serving as a referral center for bariatric operations. All the patients underwent LAGB by the pars flaccida technique. A database containing information regarding age, pre- and postoperative weight and body mass index, weight gain, and LAGB-related or -unrelated complications during pregnancy was constructed for all women of childbearing age who underwent LAGB. A questionnaire was designed to provide perinatal data concerning both mother and neonate. RESULTS: The 74 women enrolled in this study had 81 single tone pregnancies. Their body mass index decreased significantly after LAGB, from 43.3 +/- 5.8 to 30.3 +/- 3 kg/m2 at conception (p < 0.0001). The average time to the first live birth after surgery was 27 +/- 3 months. Band slippage was diagnosed and treated laparoscopically in two patients (2.4%). Weight gain during pregnancy was 10.6 +/- 2.1 kg. The rates of pregnancy-induced hypertension and gestational diabetes were 7.4% and 16% of all pregnancies, respectively. In 17 cases (20%), cesarean section was performed. Delivery occurred after 39.1 weeks of gestation. The mean birth weight was 3.09 +/- 0.5 kg. Major congenital anomalies, postnatal hypoglycemia, symptomatic polycythemia or neonatal death were not recorded. CONCLUSIONS: The findings show that LAGB is safe for both mother and newborn during gestation and delivery.

Surg Endosc. 2006 Oct;20(10):1580-3. Epub 2006 Aug 10.

Birth outcomes in obese women after laparoscopic adjustable gastric banding.

* Dixon JB, Dixon ME, O'Brien PE.

Australian Centre for Obesity Research and Education, Monash Medical School, The Alfred Hospital, Melbourne, Victoria, Australia 3004. This e-mail address is being protected from spambots. You need JavaScript enabled to view it

OBJECTIVE: This prospective study sought to examine the outcomes of 79 consecutive first pregnancies (> 20 weeks of gestation) in women following laparoscopic adjustable gastric banding (LAGB) for severe obesity. METHODS: The 79 women are from a cohort of 1,382 consecutive patients. The prospectively collected data from 79 first pregnancies has been compared with these patients' previous penultimate pregnancies (n= 40), obstetric histories from matched severely obese subjects (n = 79), and community outcomes. RESULTS: The mean maternal weight gain was 9.6 +/- 9.0 kg, compared with 14.4 +/- 9.7 kg for the 40 penultimate pregnancies of women in this group (P < .001). There was no difference in birth weights: 3,397 g compared with 3,350 g for preband pregnancies, and these were consistent with normal community birth weights. The incidence of pregnancy-induced hypertension (10%) and gestational diabetes (6.3%) were comparable with community levels (12% and 5.5%) and lower than the obese cohort (38% and 19%) and these patients' penultimate pregnancies (45% and 15%). Monitoring and, if necessary, band adjustments during pregnancy provided more favorable maternal weight outcomes (P = .027). Neonatal outcomes, including stillbirths, preterm deliveries, low birth weight, and high birth weight, were consistent with community values. One woman developed anemia during pregnancy. CONCLUSION: Pregnancy outcomes after LAGB are consistent with general community outcomes rather than outcomes from severely obese women. The adjustability of the LAGB assists in achieving these outcomes. Adjustability is appealing because it allows adaptation to the altered requirements of pregnancy. LEVEL OF EVIDENCE: II-2.

Obstet Gynecol. 2005 Nov;106(5 Pt 1):965-72.

Laparoscopic adjustable banding in pregnancy: safety, patient tolerance and effect on obesity-related pregnancy outcomes.

* Skull AJ, Slater GH, Duncombe JE, Fielding GA.

Wesley Obesity Clinic, Wesley Hospital, Brisbane, Queensland, Australia.

BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) is increasingly recommended to women of reproductive age. For continued use, LAGB needs to be proven to be safe and well-tolerated during pregnancy. Maternal obesity is a well-recognized risk factor for gestational diabetes, maternal hypertension and is more likely to result in instrumental delivery or caesarean section. Weight control with the LAGB may reduce the incidence of these complications. METHODS: An observational study was conducted of the LAGB in pregnancy, including a study comparing outcomes of LAGB pregnancies with previous non-LAGB pregnancies. Women who had had successful LAGB pregnancies were identified from a computerized database. A telephone questionnaire was used to collect the additional outcome data needed and was administered by an independent medical practitioner. RESULTS: 49 LAGB and 31 previous non-LAGB pregnancies were included. 2 LAGBs (4%) required removal during pregnancy. Mean maternal weight gain was significantly reduced in the LAGB group, 3.7 kg vs 15.6 kg (P <0.0001), with no effect on fetal weight, 3.31 vs 3.53 kg, or neonatal complications, 4% and 3%. The incidence of gestational diabetes, 8 and 27% (P =0.048), and hypertension, 8 and 22.5% (P =0.06) was significantly reduced in the LAGB group. The overall complication rate during pregnancy for LAGB was 20.4% and 52% for non-LAGB (P =0.0037) CONCLUSION: LAGB is safe and well-tolerated during pregnancy with a lower incidence of gestational diabetes and maternal hypertension. LAGB can be safely recommended to morbidly obese women of childbearing age.

Obes Surg. 2004 Feb;14(2):230-5.



 

BMI Calculator