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. 2013 Apr 30;2013(4):CD010048.
doi: 10.1002/14651858.CD010048.pub2.

Deflation of gastric band balloon in pregnancy for improving outcomes

Amanda E Jefferys  1 , Dimitrios Siassakos, Tim Draycott, Valentine A Akande, Robert Fox
Affiliations

Deflation of gastric band balloon in pregnancy for improving outcomes

Amanda E Jefferys et al. Cochrane Database Syst Rev. .

Abstract

Background: In line with the rise in the prevalence of obesity, an increasing number of women of childbearing age are undergoing laparoscopic adjustable gastric banding (LAGB), resulting in an increasing number of pregnancies with a band in place. Currently, there is no consensus on optimal band management in pregnancy. Some clinicians advocate leaving the band balloon inflated to reduce gestational weight gain and associated adverse perinatal outcomes. However, there are concerns that maintaining balloon inflation during pregnancy might increase the risk of band complications and adversely affect fetal development and/or growth as a result of reduced nutritional intake.

Objectives: To compare maternal and perinatal outcomes for elective gastric band balloon deflation versus intention to maintain balloon inflation during pregnancy.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2012) and the Web of Science database (1940 to September 2012).

Selection criteria: Randomised-controlled trials comparing elective deflation of the gastric band balloon with intention to maintain balloon inflation in pregnant women who have undergone LAGB.

Data collection and analysis: Two review authors independently assessed studies for inclusion.

Main results: No studies met the criteria for inclusion in the review.

Authors' conclusions: To date no randomised controlled trials exist that compare elective deflation of the gastric band balloon in pregnancy versus intention to maintain balloon inflation. Further research is needed to define the optimum management of the gastric band balloon in pregnancy.

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Conflict of interest statement

The authors are involved in a national surveillance study (UKOSS) of the management of gastric banding in pregnancy, which would not be eligible for inclusion in this systematic review. They have no known conflict of interest.

Figures

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Study flow diagram.
See this image and copyright information in PMC

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References

Additional references

Carelli 2011
    1. Carelli AM, Ren CJ, Youn HA, Friedman EB, Finger AE, Lok BH, et al. Impact of laparoscopic adjustable gastric banding on pregnancy, maternal weight, and neonatal health. Obesity Surgery 2011;21(10):1552‐8. - PubMed
Chapman 2004
    1. Chapman AE, Kiroff G, Game P, Foster B, O'Brien P, Ham J, et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery 2004;135(3):326‐51. - PubMed
Chevallier 2004
    1. Chevallier J, Zinzindohoue F, Douard R, Blanche J, Berta J, Altman J, et al. Complications after laparoscopic adjustable gastric banding for morbid obesity: experience with 1000 patients over 7 years. Obesity Surgery 2004;14(3):407‐14. - PubMed
CMACE 2010
    1. CMACE/RCOG Joint Guideline. Management of Women with Obesity in Pregnancy. London: Jointly published by the Centre for Maternal and Child Enquiries and the Royal College of Obstetricians and Gynaecologists, 2010.
CMACE 2011
    1. Centre for Maternal and Child Enquiries (CMACE). Saving Mother's Lives: reviewing maternal deaths to make motherhood safer: 2006‐08. The Eighth Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. British Journal of Obstetrics and Gynaecology 2011;118(Suppl 1):1‐203. - PubMed
Colquitt 2009
    1. Colquitt JL, Picot J, Loveman E, Clegg AJ. Surgery for obesity. Cochrane Database of Systematic Reviews 2009, Issue 2. [DOI: 10.1002/14651858.CD003641.pub3] - DOI - PubMed
Dixon 2001
    1. Dixon JB, Dixon ME, O'Brien PE. Pregnancy after Lap‐Band surgery: management of the band to achieve healthy weight outcomes. Obesity Surgery 2001;11(1):59‐65. - PubMed
Dixon 2005
    1. Dixon JB, Dixon ME, O'Brien PE. Birth outcomes in obese women after laparoscopic adjustable gastric banding. Obstetrics and Gynecology 2005;106(5 Pt 1):965‐72. - PubMed
Dodd 2010
    1. Dodd JM, Grivell RM, Crowther CA, Robinson JS. Antenatal interventions for obese or overweight pregnant women: a systematic review of randomised trials. British Journal of Obstetrics and Gynaecology 2010;117(11):1316‐26. - PubMed
Egger 1997
    1. Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta‐analysis detected by a simple, graphical test. BMJ 1997;315(7109):629‐34. - PMC - PubMed
Forsell 1999
    1. Forsell P, Hallerback B, Glise H, Hellers G. Complications following Swedish adjustable gastric banding: a long‐term follow‐up. Obesity Surgery 1999;9(1):11‐6. - PubMed
Guelinckx 2009
    1. Guelinckx I, Devlieger R, Vansant G. Reproductive outcome after bariatric surgery: a critical review. Human Reproduction Update 2009;15(2):189‐201. - PubMed
Harbord 2006
    1. Harbord RM, Egger M, Sterne JA. A modified test for small‐study effects in meta‐analyses of controlled trials with binary endpoints. Statistics in Medicine 2006;25(20):3443‐57. - PubMed
Higgins 2011
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Institute of Medicine 2009
    1. Institute of Medicine. Weight gain during pregnancy: reexamining the guidelines. Institute of Medicine Guideline 2009.
Jefferys 2012
    1. Jefferys AE, Siassakos D, Draycott T, Akande VA, Fox R. Deflation of gastric band balloon in pregnancy for improving outcomes. Cochrane Database of Systematic Reviews 2012, Issue 8. [DOI: 10.1002/14651858.CD010048] - DOI - PMC - PubMed
Jensen 2005
    1. Jensen DN, Ovesen P, Beck Nielsen H, Molsted‐Pedersen L, Sorensen B, Vinter C, et al. Gestational weight gain and pregnancy outcomes in 481 obese glucose tolerant women. Diabetes Care 2005;28:2118‐22. - PubMed
Kiel 2007
    1. Kiel DW, Dodson EA, Artal R, Boehmer TK, Leet TL. Gestational weight gain and pregnancy outcomes in obese women ‐ how much is enough?. Obstetrics and Gynecology 2007;110(4):752‐8. - PubMed
Knight 2010
    1. Knight M, Kurinczuk JJ, Spark P, Brocklehurst P. Extreme obesity in pregnancy in the United Kingdom. Obstetrics and Gynecology 2010;115:989‐97. - PubMed
Lapolla 2010
    1. Lapolla A, Marangon M, Dalfra MG, Segato G, Luca M, Fedele D, et al. Pregnancy outcome in morbidly obese women before and after laparoscopic gastric banding. Obesity Surgery 2010;20(9):1251‐7. - PubMed
Maggard 2008
    1. Maggard MA, Yermilov I, Li Z, Maglione M, Newberry S, Suttorp M, et al. Pregnancy and fertility following bariatric surgery: a systematic review. JAMA 2008;300(19):2286‐96. - PubMed
Mamun 2011
    1. Mamun A, Callaway LK, O'Callaghan MJ, Williams GM, Najman J, Alati R, et al. Associations of maternal pre‐pregnancy obesity, and excess pregnancy weight gains with adverse pregnancy outcomes and length of hospital stay. BMC Pregnancy & Childbirth 2011;11:62. - PMC - PubMed
Martin 2000
    1. Martin LF, Finigan KM, Nolan TE. Pregnancy after adjustable gastric banding. Obstetrics and Gynecology 2000;95(6 Pt 1):927‐30. - PubMed
RevMan 2011 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Salihu 2011
    1. Salihu HM. Maternal obesity and stillbirth. Seminars in Perinatology 2011;35:340‐4. - PubMed
Schieve 2000
    1. Schieve L, Cogswell M, Scanlon K, Perry G, Ferre C, Blackmore‐Prince C, et al. Pre‐pregnancy body mass index and pregnancy weight gain: associations with preterm delivery. Obstetrics and Gynecology 2000;96(2):194‐200. - PubMed
Sheiner 2009
    1. Sheiner E, Balaban E, Dreiher J, Levi I, Levy A. Pregnancy outcome in patients following different types of bariatric surgeries. Obesity Surgery 2009;19(9):1286‐92. - PubMed
Siega‐Riz 2009
    1. Siega‐Riz AM, Viswanathan M, Moos M, Mumford S, Knaack J, Thieda P, et al. A systematic review of outcomes of maternal weight gain according to the Institute of Medicine recommendations: birthweight, fetal growth and postpartum weight retention. American Journal of Obstetrics and Gynaecology 2009;201(4):339. - PubMed
Skull 2004
    1. Skull AJ, Slater GH, Duncombe JE, Fielding GA. Laparoscopic adjustable banding in pregnancy: safety, patient tolerance and effect on obesity‐related pregnancy outcomes. Obesity Surgery 2004;14(2):230‐5. - PubMed
Stothard 2009
    1. Stothard KJ, Tennant PWG, Bell R, Rankin J. Maternal overweight and obesity and the risk of congenital anomalies: a systematic review and meta‐analysis. JAMA 2009;301(6):636‐50. - PubMed
Stotland 2006
    1. Stotland N, Cheng Y, Hopkins L, Caughey A. Gestational weight gain and adverse neonatal outcome among term infants. Obstetrics and Gynecology 2006;108(3):635‐43. - PubMed
Strauss 1999
    1. Strauss RS, Dietz WH. Low maternal weight gain in the second or third trimester increases the risk for intrauterine growth retardation. Journal of Nutrition 1999;129:988‐93. - PubMed
Usha Kiran 2005
    1. Usha Kiran TS, Hemmadi S, Betgel J, Evans J. Outcome of pregnancy in a woman with an increased body mass index. British Journal of Obstetrics and Gynaecology 2005;112:768‐72. - PubMed
Weiss 2001
    1. Weiss HG, Nehoda H, Labeck B, Hourmont K, Marth C, Aigner F. Pregnancies after adjustable gastric banding. Obesity Surgery 2001;11(3):303‐6. - PubMed
WHO
    1. World Health Organization. Maternal and perinatal health. http://www.who.int/maternal_child_adolescent/topics/maternal/maternal_pe... (accessed 27/03/2012).
WHO 2001
    1. World Health Organization. Iron deficiency anaemia: Assessment, prevention, and control. A guide for programme managers. whqlibdoc.who.int/hq/2001/WHO_NHD_01.3.pdf (accessed 01/04/2012).

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