Vitamin A deficiency in a newborn resulting from maternal hypovitaminosis A after biliopancreatic diversion for the treatment of morbid obesity.
ABSTRACT Biliopancreatic diversion (BPD) has been advocated for the treatment of morbid obesity. This procedure has the theoretical advantage that patients retain normal eating capacity and lose weight irrespective of their eating habits. However, vitamin deficiencies may develop because BPD causes malabsorption.
This report describes a 40-y-old mother and her newborn infant, who developed vitamin A deficiency as a result of iatrogenic maternal malabsorption after BPD. Our primary objective is to show that BPD patients need close follow-up and lifelong micronutrient supplementation to prevent nutrient deficiencies in themselves and their offspring.
The medical records of the mother and infant were reviewed, and their clinical course was followed until 10 mo postpartum. The mother was also interviewed on several occasions about her medical care, follow-up, and supplemental vitamin use.
The mother developed night blindness with undetectable serum vitamin A concentrations in the third trimester of her pregnancy. Her vitamin A deficiency was untreated until she delivered her infant. At delivery, the infant also had vitamin A deficiency. He may have permanent retinal damage, but this is still unclear because the ophthalmologic examination performed at 2 mo of age was inconclusive.
Complications of BPD may take many years to develop, and the signs and symptoms may be subtle. Because of the malabsorption that results from BPD, patients need lifelong follow-up and appropriate vitamin supplementation to prevent deficiencies. These nutrient deficiencies can also affect the offspring of female BPD patients.
Full-textDOI: · Available from: Sergio Huerta, May 09, 2015
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ABSTRACT: Le nombre de femmes jeunes opérées d’obésité morbide (OM) ne cesse de croître en France. Toutes sont susceptibles d’avoir des enfants. Le but de cet article était de décrire à partir d’une revue de la littérature les étapes de prise en charge d’une femme enceinte opérée d’OM et la prévention des complications foeto-maternelles. Il existe encore de nombreuses controverses et les connaissances restent partielles. Un chirurgien viscéral impliqué dans la chirurgie bariatrique se doit de connaître ce sujet. Son action de surveillance devra être intégrée à chaque étape avec un gynécologue obstétricien et la patiente.Obésité 09/2012; 7(3). DOI:10.1007/s11690-012-0339-4
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ABSTRACT: Background: Obesity is the most frecuent metabolic disease in the World, and is associated with several comorbidities. Bariatric procedures arise as a promising treatment when classical approach is ineffective. Half of the operated patients are reproductive-aged women and there is evidence that obesity is related to worse maternal and fetal outcomes. Because nutritional status is affected by bariatric surgery and is a vital component during pregnancy, the aim of our study is to asses the impact of bariatric surgery on pregnancy in these pacients. Material and methods: We studied 10 women and 15 pregnancies following bariatric surgery between 2003 and 2009. The visits took place every three months by an obstetrician and an endocrinologist with experience in nutrition, recording clinical features and lab work. Results: We found iron deficiency in 80% of the pregnancies, vitamin D in 46,7%, vitamin A in 20%, vitamin E in 13,3% and vitamin B12 in 26,7%. There were no complications during pregnancy, except one case of gravidic hiperemesis. There were nine deliveries without malformations, three of them were small for gestational age newborns and one suffered aspiration pneumonia. There were three stillbirths and one preterm delivery with fetal death. Conclusions: our results show fewer complications during pregnancy in these women than obese women and similar to general population.Nutricion hospitalaria: organo oficial de la Sociedad Espanola de Nutricion Parenteral y Enteral 04/2011; 26(2):376-383. · 1.25 Impact Factor
Article: Chirurgie bariatrique et obstétrique[Show abstract] [Hide abstract]
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