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Master Thesis

Impact de la chirurgie bariatrique sur la grossesse : étude rétrospective chez les patientes présentant une obésité morbide

Abstract : Objective : France counts today 14.8 millions of people overweight and 6.9 millions people obese. Obesity poses a significant risk to reproductive-aged women. Bariatric surgery is more and more suggested to help patients in morbid obesity lose significant weight. The main goal of the study is to analyse the impact of bariatric surgery on morbid obesity patients studying maternal , obstetrical and neonatal outcomes on those patients. Methods : A retrospective study was made of 38 post-bariatric surgery pregnancies with an IMC > 40 kg/m2 in pre-surgery compared to 81 mobid obesity pregnancies which IMC > 40 kg/m2 non operated. Weight gain pregnancies, pregnancy complications, deliveries, neonatal outcomes and the impact of time between surgery and delivery were analysed. Results and conclusion : The post-bariatric surgery patients gained more significant weight than non-operated patients (p=0.01). However they developed less gestational diabetes (p=0.005). There were less cervical maturation (p=0.002) but more induction of labour (p=0.005) in the post-surgery group of patients and there were less emergency cesarians as well (p=0.01). The neonatal outcomes were similiar in both groups. As far as the pregnancy course and the delivery itself were concerned there were no significant difference according to the delay (>18 months) between surgery and the beginning of the pregnancy. Finally, the post-bariatric surgery patients (Gastric banding and Sleeve gastrectomy) gave birth to more macrosomia newborns (p=0.001). Bariatric surgery improves obstetric and neonatal and maternal prognosis..There is no significant impact concerning the neonatal prognosis in this study. A multidisciplinary follow-up is compulsory in order to avoid nutritional deficiencies or important weight gain during pregnancy.
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Submitted on : Thursday, October 22, 2015 - 4:42:55 PM
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Soleen Camus. Impact de la chirurgie bariatrique sur la grossesse : étude rétrospective chez les patientes présentant une obésité morbide. Gynécologie et obstétrique. 2015. ⟨dumas-01219436⟩



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