Les dix points essentiels de la chirurgie bariatrique et obstétrique

摘要

Obesity is a public health problem, with an incidence not ceasing growing during the last years in Europe and in the USA. Bariatric surgery is the last recourse for these patients with a morbid obesity, in association to hygienodietetic rules, pharmacological treatments, and behavioral therapies. Among women in age to procreate, this surgery of obesity decreases morbi-mortality, and reduces obstetrical complications: gestational diabetes, arterial hypertension, preeclampsia, fetal malformations related to obesity, etc. The two techniques of surgery of obesity are the restrictive techniques (laparoscopic adjustable gastric banding, sleeve gastric) and the malabsorptive techniques. Nowadays, in France, gastric sleeve or longitudinal gastrectomy is the first technique suggested. The malabsorptive techniques involve deficiencies into micro nutriments which have to be detected by a preconceptional assessment and supplemented as soon as possible during the pregnancy in order to avoid any induced fetal malformation. By a review of the literature, the purpose of the present study is to deal with the ten essential points in obstetric care after a bariatric surgery, and the multidisciplinary follow-up to make sure of good psychological and nutritional balance. The aim of such management is to ensure the normal progress of pregnancy and the birth of newborns without deficiency or malformation.