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复杂减重手术后维生素K缺乏导致的胎儿脑出血

Fetal cerebral hemorrhage caused by vitamin K deficiency after complicated bariatric surgery.

作者信息

Van Mieghem Tim, Van Schoubroeck Dominique, Depiere Marc, Debeer Anne, Hanssens Myriam

机构信息

Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.

出版信息

Obstet Gynecol. 2008 Aug;112(2 Pt 2):434-6. doi: 10.1097/AOG.0b013e3181649e7b.

Abstract

BACKGROUND

Restrictive bariatric surgery decreases obesity-related morbidity and mortality. With the widespread use of these interventions, an increasing number of women who have undergone bariatric surgery become pregnant.

CASE

A women, pregnant 2 years after laparoscopic gastric banding, presented with prolonged vomiting due to slippage of the gastic band resulting in gastric outlet obstruction. Parenteral feeding was initiated for 3 weeks until the patient was delivered because of a nonreassuring fetal heart rate pattern. A postnatal diagnosis of an extensive intracranial fetal hemorrhage due to maternal vitamin K deficiency was made.

CONCLUSION

Although restrictive bariatric surgery is generally considered safe, we want to warn of possible severely adverse outcomes related to the intervention. In case of food intolerance, early vitamin substitution is indicated.

摘要

背景

限制性减肥手术可降低肥胖相关的发病率和死亡率。随着这些干预措施的广泛应用,越来越多接受减肥手术的女性怀孕。

病例

一名女性在腹腔镜胃束带手术后2年怀孕,因胃束带滑落导致胃出口梗阻而出现长期呕吐。由于胎儿心率模式不稳定,在患者分娩前开始了3周的肠外营养支持。产后诊断为因母体维生素K缺乏导致胎儿广泛颅内出血。

结论

尽管限制性减肥手术通常被认为是安全的,但我们想提醒可能存在与该干预相关的严重不良后果。在出现食物不耐受的情况下,建议早期补充维生素。

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