Royal Prince Alfred Hospital, 50 Missenden Rd, Camperdown, Sydney, NSW, Australia.
Sunshine Coast University Hospital, Birtinya, QLD, Australia.
Aesthetic Plast Surg. 2023 Aug;47(4):1472-1479. doi: 10.1007/s00266-023-03423-x. Epub 2023 Jun 2.
BACKGROUND: As advanced maternal age and bariatric procedures have become more common, the number of women seeking pregnancy after having abdominoplasty has increased. This has traditionally been a relative contraindication and counselled against, though there are little data in the literature regarding the potential effects to mother and baby. METHODS: A systematic review of Medline and Embase databases was performed to identify cases of pregnancy occurring after abdominoplasty. Data were extracted and analysed for presentation. RESULTS: 17 studies encompassing 237 patients met inclusion. Mean age was 33.08 years. Mean parity prior to first pregnancy after abdominoplasty 2.13. Previous bariatric surgery was reported in 31.75%. Body contouring procedure was abdominoplasty (94.51%), body lift (3.80%) and other (1.69%). Rectus plication was performed in 89.74%, where reported. Mean time between abdominoplasty and pregnancy was 3.75 years. Method of delivery was Caesarean section in 43.63%, and vaginal delivery in 56.37%. Mean gestational age at delivery was 38.90 weeks. Preterm delivery (<37 weeks) was reported in 9.85%, and low birthweight (<2500 g) was reported in 7.22%. Diagnoses or complications were documented in 14 studies (136 patients). These were grouped as foetal/neonatal (n = 21), maternal (n = 104) or abdominal wall/aesthetic (n = 96); and are detailed within. There were no neonatal or maternal mortalities in any study. A lower-than-expected spinal anaesthetic block was stated in 3 cases. Mean follow-up was 8.5 months. CONCLUSION: Pregnancy should not be contraindicated after abdominoplasty. The data presented allow clinicians to have an evidence-based discussion and provide information for shared decision-making. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
背景:随着高龄产妇和减重手术的增多,接受过腹部整形手术的女性再次怀孕的人数有所增加。传统上,这是一个相对的禁忌症,不建议此类患者再次怀孕,尽管文献中几乎没有关于母亲和婴儿潜在影响的相关数据。
方法:对 Medline 和 Embase 数据库进行了系统回顾,以确定腹部整形术后发生的妊娠病例。提取并分析数据以进行展示。
结果:共纳入 17 项研究,涵盖 237 例患者。平均年龄为 33.08 岁。腹部整形术后首次妊娠的平均产次为 2.13。既往有 31.75%的患者接受过减重手术。腹部整形术(94.51%)、身体提升术(3.80%)和其他术式(1.69%)是最常采用的身体塑形术式。有报道称,89.74%的患者进行了腹直肌折叠术。腹部整形术与妊娠之间的平均时间为 3.75 年。剖宫产分娩占 43.63%,阴道分娩占 56.37%。平均分娩孕周为 38.90 周。早产(<37 周)发生率为 9.85%,低出生体重(<2500g)发生率为 7.22%。有 14 项研究(136 例患者)记录了诊断或并发症。这些研究分为胎儿/新生儿组(n=21)、母亲组(n=104)或腹壁/美学组(n=96),并在文中详细列出。在任何研究中均未发生新生儿或产妇死亡。3 例患者出现低于预期的脊髓麻醉阻滞。平均随访时间为 8.5 个月。
结论:腹部整形术后不应禁止妊娠。本文提供的数据使临床医生能够进行基于证据的讨论,并为共同决策提供信息。
证据等级 III:本杂志要求作者为每篇文章分配一个证据等级。有关这些循证医学评级的完整描述,请参阅目录或在线作者指南 www.springer.com/00266。
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