Obesity Surgery 2001: 11: 59-65
Dixon JB, Dixon ME, O'Brien PE. Pregnancy after lap band surgery: Management of the band to achieve healthy weight outcomes
Severely obese women have higher obstetric risks and poorer neonatal outcomes. Weight loss increases fertility and reduces the risk of obsteteric complications in obese women. The introduction of the laparoscopic adjustable gastric band has provided a safe and effective method of weight loss and it requires appropriate adjustment during pregnancy.
In this study of 650 patients undergoing lap-banding, the authors identified 20 women who had completed a total of 22 pregnancies. As early as possible during the pregnancy, all fluid was removed from the band to minimize band restriction and to allow optimal nutrition during the pregnancy. Optimal weight gain was discussed with all women and fluid was added to the band (thereby increasing restriction) after 14 weeks of pregnancy. The object was to limit excessive weight gain rather than to assist with weight loss.
At 36 weeks of pregnancy, the band was again emptied of all fluid to minimize its impact on delivery. Once lactation was established, the band was adjusted to near pre-pregnancy levels of restriciton to allow for continued weight loss.
All 22 pregnancies were successful and obstetric complications were minimal. Mean maternal weight gain was 8.3 kg compared with 15.2 kg for the 15 previous pregnancies of women in this group.
The authors conclude that active management which utilises the adjustability of the lap band achieves optimal weight control and appreas to be associated with a reduction of the risks and complications of pregnancy for the mother and infant.
