title: [Assessment of fetal vitality and perinatal results in pregnancies after gastroplasty with Roux-en-Y gastric bypass].
abstract: OBJECTIVE
  To study fetal vitality assessed in pregnancies after gastroplasty with Roux-en-Y gastric bypass and verify maternal complications and perinatal results.
  
  
  METHODS
  Hospital charts of all pregnancies after gastroplasty with Roux-en-Y gastric bypass were reviewed retrospectively. All cases followed at the specialized prenatal care that gave birth in this institution, between July 2001 and September 2009, were reviewed. The assessment of fetal vitality (cardiotocography, fetal biophysical profile and umbilical artery Doppler velocimetry) performed in the last week before delivery were analyzed. The maternal variables investigated were: demographic data, maternal complications, mode of delivery, complications during delivery and postpartum, maternal blood exams and perinatal results.
  
  
  RESULTS
  During the study period 30 pregnancies after gastroplasty with Roux-en-Y gastric bypass were identified and 24 of them had undergone assessment of fetal vitality. All patients presented normal cardiotocography, normal fetal biophysical profile and normal results at the umbilical artery Doppler velocimetry. One case presented with oligohydramnios. The main complication observed was maternal anemia (Hb < 11.0 g/dL, 86.7%). Cesarean section was performed in 21 pregnancies (70%). Delivery complications included one case of adherences, one hematoma and infection of abdominal wall scar and one postpartum hysterectomy for myoma and uterine atony. The proportion of small infants for gestational age was 23.3%.
  
  
  CONCLUSIONS
  Fetal vitality was not compromised in pregnancies after gastroplasty with Roux-en-Y gastric bypass. The main maternal complication was anemia, therefore these women require specific nutritional counseling and a broad evaluation for micronutrient deficiencies at early pregnancy.
authors.affiliation: Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP.
authors.forename: Roseli Mieko Yamamoto
authors.initials: RM
authors.lastname: Nomura
authors.forename: Maria Carolina Gonçalves
authors.initials: MC
authors.lastname: Dias
authors.forename: Ana Maria Kondo
authors.initials: AM
authors.lastname: Igai
authors.forename: Adolfo Wenjaw
authors.initials: AW
authors.lastname: Liao
authors.forename: Seizo
authors.initials: S
authors.lastname: Miyadahira
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000328:Adult; D000740:Anemia / Q000209:etiology*; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005323:Fetal Monitoring / Q000379:methods*; D015390:Gastric Bypass / Q000009:adverse effects*; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D009752:Nutritional Status / Q000502:physiology; D007744:Obstetric Labor Complications; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000209:etiology*; D011295:Prenatal Care; D012189:Retrospective Studies