Jasaitis Y, Sergent F, Bridoux V, Paquet M, Marpeau L, Ténière P
Service de gynécologie obstétrique, CHU de Rouen, 76031 Rouen cedex, France.
J Gynecol Obstet Biol Reprod (Paris). 2007 Dec;36(8):764-9. doi: 10.1016/j.jgyn.2007.03.010. Epub 2007 May 23.
To report our experience of the association adjustable gastric banding and pregnancy. To define a management for a such association.
Retrospective and descriptive study on two centers over a 3-year follow-up of pregnancies begun with a Lap-Band gastric banding placed by laparoscopic way.
Twenty-one pregnancies, 22 newborns resulting from 18 women were identified. Eleven patients were hospitalized. The motive of the hospitalization was severe epigastralgia for four patients requiring three deflations for mechanical complication. No case of preeclampsia was identified. Seven bands were deflated. In the group of the deflated bands, the mean maternal weight gain was 19 vs 10 kg (P=0.008), the mean birth weight was 3700 vs 3204 g (P=0.09) with a rate of fetal macrosomia increased, 50 vs 29% (P=0.038). The difference between the rates of cesarean delivery was not significant (NS) between the two groups. The childbirth term was appreciably the same, 39.4 vs 38.6 weeks of gestation (NS). The only case of gestational diabetes was found in the deflated band group. Three intrauterine growth restrictions whose one fetal death occurred in the not deflated band group.
Results obtained were comparable to those of the literature. This series confirms that adjustable gastric banding limits the usual complications of the morbid obesity during pregnancy. It is generally well tolerated and must not be thus deflated by principle, but only on symptoms. That will be a total dysphagia, severe epigastric pains, vomiting after the first trimester of pregnancy or an intrauterine growth restriction.
报告我们关于可调节胃束带术与妊娠相关的经验。定义针对这种联合情况的管理方法。
对两个中心进行回顾性描述性研究，对通过腹腔镜放置Lap - Band胃束带后开始的妊娠进行为期3年的随访。
共识别出21次妊娠，来自18名女性的22名新生儿。11名患者住院。住院原因是4名患者出现严重上腹痛，因机械性并发症需要进行3次放气操作。未发现先兆子痫病例。7条束带被放气。在放气束带组中，母亲平均体重增加为19千克，而未放气组为10千克（P = 0.008），平均出生体重为3700克，未放气组为3204克（P = 0.09），巨大儿发生率增加，分别为50%和29%（P = 0.038）。两组剖宫产率差异无统计学意义（NS）。分娩孕周大致相同，分别为39.4周和38.6周（NS）。仅在放气束带组发现1例妊娠期糖尿病。未放气束带组出现3例胎儿生长受限，其中1例胎儿死亡。
获得的结果与文献报道的结果相当。该系列研究证实可调节胃束带术可限制妊娠期病态肥胖的常见并发症。其耐受性一般良好，原则上不应放气，仅在出现以下症状时放气：完全吞咽困难、严重上腹部疼痛、妊娠早期后呕吐或胎儿生长受限。
