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Successful Management of Pregnancy After Bariatric Surgery

Successful Management of Pregnancy After Bariatric Surgery. Remesova T Jones L, Heath D, Sufi P Bariatric Surgery Department Whittington Hospital, London. United Kingdom. What algorithm is optimal?. Nutrition Surgical issues Obstetrical issues. What algorithm is optimal?.

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Successful Management of Pregnancy After Bariatric Surgery

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  1. Successful Management of Pregnancy After Bariatric Surgery Remesova T Jones L, Heath D, Sufi P Bariatric Surgery Department Whittington Hospital, London. United Kingdom

  2. What algorithm is optimal? • Nutrition • Surgical issues • Obstetrical issues

  3. What algorithm is optimal? • Nutrition • Surgical issues • Obstetrical issues

  4. What new you will hear? • Local algorithm • Roles in the multidisciplinary team – dietician, surgeon, obstetrician/midwife • 20 patients, 22 pregnancies • 1 week to 36 months post operatively

  5. 1. dietician • Adjustment of supplements – vitamin A • Eating habits • Nutrition • Blood profile Zinc B12 / folic acid Haemoglobin / iron Vitamin D

  6. 2. surgeon • Band adjustment • Potential surgical issues

  7. restrictive Stretching the pouch Band adjustment Band slippage Stretching the pouch Gastric BAND SLEEVE gastrectomy

  8. Restrictive & malabsorbtive Malnutrition Internal hernias Ulcers Gastric BYPASS Duodenal SWITCH / Biliopancreatic bypass

  9. 3. Obstetrician / midwife • Obesity + O&G risk assessment • Avoid oGTT in malabsorbtiveprocedures • Avoidpreferably oral contraceptive • Immediate referral to dietician • Low threshold for surgical referral

  10. ALGORITHM

  11. Our results • Early referrals good outcome • Late referral IUGR  CS 30 weeks • Frequent vitamin deficiencies  corrected • 2 subsequent pregnancies in two years  no weight loss

  12. Thank you! Tereza.Remesova@nhs.net ObsGynae.net

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