Surveillance of pregnancy after gastric band surgery

Summary

The impact of obesity on pregnancy is well established; obesity negatively impacts on maternal, fetal and neonatal wellbeing. Laparoscopic Adjustable Gastric Band (LAGB) insertion is the primary surgical method of surgical weight reduction in the UK. It involves application of an adjustable silicone balloon around the upper portion of the stomach, resulting in a small upper stomach pouch and a narrowed outlet, which limits the stomach's capacity to intake food and increases the feeling of fullness. These two effects assist subsequent weight loss. LAGB insertion is increasing rapidly both in the private sector and in the NHS, with an estimated 1,700 bands inserted in women under the age of 40 years in 2007. The increase in gastric banding in women of reproductive age has resulted in increasing numbers of pregnancies following gastric banding.

Nevertheless, management of pregnancy following gastric band surgery has not been well defined. In most reports, women who conceive following LAGB have the band deflated for the duration of the pregnancy because of concerns regarding hyperemesis and poor nutritional intake. Deflating the gastric band has the adverse effect of excessive weight gain and subsequent pregnancy complications. However, pregnancy following LAGB has been shown to be well tolerated and studies have also demonstrated a reduction in incidence of gestational diabetes, maternal hypertension and caesarean delivery when compared to obese controls.

The aims of this study were to use the UK Obstetric Surveillance System to describe the epidemiology and management of gastric banding in pregnancy in the UK and to use this information to assess current practice and develop future guidelines for optimal management.Data anlysis is currently in progress.