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The Impact of Upper Abdominal Pain During Pregnancy Following a Gastric Bypass

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Abstract

Objective

The aim of the present study was to describe the risk of internal herniation (IH) and the obstetric outcome in pregnant women with Roux-en-Y gastric bypass (RYGB) and episodes of upper abdominal pain.

Methods

The cohort included 133 women with RYGB: 94 with 113 pregnancies, from the local area referred for routine antenatal care (local cohort) and 39 with 40 pregnancies referred from other hospitals for specialist consultation due to RYGB. RYGB was mainly performed without closure of the mesenteric defects. Data collected from medical records were episodes of upper abdominal pain, pregestational and gestational abdominal surgery and pregnancy outcome. The risk of upper abdominal pain was estimated in the local cohort. Surgical intervention, IH and obstetric outcome according to pain were evaluated for 139 pregnancies with delivery of a singleton after 24 weeks of gestation (birth cohort).

Results

Upper abdominal pain complicated 42/113 (37.2 %) pregnancies in the local cohort and 11 women (9.7 %) had IH. In the birth cohort, upper abdominal pain complicated 64/139 (46.0 %) pregnancies; surgery was performed in 30/64 (46.9 %), and IH diagnosed in 21/64 (32.8 %). The median gestational age at onset of pain was 25 + 3 weeks. Women reporting abdominal pain had a higher risk of preterm birth (n = 14/64 vs. 1/75, p < 0.005), lower median gestational length (269 vs. 278 days, p < 0.005) and lower median birth weight (3018 vs. 3281 g, p = 0.002) compared to women without abdominal pain.

Conclusions

Upper abdominal pain during pregnancy is frequent among women with Roux-en-Y gastric bypass, is often due to IH and is associated with adverse pregnancy outcome.

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Acknowledgments

The authors would like to acknowledge the contribution of Mette Visholm, secretary at the Department of Obstetrics and Gynaecology, Copenhagen University Hospital Hvidovre, Denmark, for her help in retrieving medical records.

Contribution to Authorship

LP and JL contributed to the study design, data collection and wrote the manuscript draft; LN contributed to the study design and data collection, and JS contributed to the data collection. All authors have contributed to and accepted the final manuscript.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark

    Liselotte Petersen & Lisbeth Nilas

  2. Department of Obstetrics and Gynecology, Copenhagen University Hospital Herlev, Herlev Ringvej 75, 2730, Herlev, Denmark

    Jeannet Lauenborg & Jens Svare

Authors
  1. Liselotte Petersen
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  2. Jeannet Lauenborg
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  3. Jens Svare
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  4. Lisbeth Nilas
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Corresponding author

Correspondence to Jeannet Lauenborg.

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Ethical Approval

The Danish board of Data Protection approved the study (Journal Number 2012-41-1006).

Conflict of Interest

The authors declare that they have no conflict of interest.

Funding

No funding was received for this study.

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Petersen, L., Lauenborg, J., Svare, J. et al. The Impact of Upper Abdominal Pain During Pregnancy Following a Gastric Bypass. OBES SURG 27, 688–693 (2017). https://doi.org/10.1007/s11695-016-2339-1

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  • DOI: https://doi.org/10.1007/s11695-016-2339-1

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