title: Acute fetal asphyxia after gastric rupture in a pregnant patient with a gastric band.
abstract: We report a 37-year-old primigravida with a gastric band who developed the clinical picture of abdominal pain, vomiting and regurgitation coexistent with a cardiotocogram with severe variable decelerations with absent variability at 33 weeks' gestation. After partial improvement with gastric band enlargement, new aggravation of symptoms and recurrence of a pathological cardiotocogram led to an emergency cesarean section. Intraoperatively, hemoperitoneum from gastric rupture was verified and partial gastrectomy was performed. After bariatric surgery, pregnant women are at increased risk of gastrointestinal complications, which may need prompt and multidisciplinary diagnosis and management in order to avoid maternal-fetal morbidity and mortality.
authors.affiliation: Department of Obstetrics and Gynecology, Central Hospital of Lisbon North (CHLN) - Hospital of Santa Maria, Lisbon, Portugal.
authors.forename: Catarina
authors.initials: C
authors.lastname: Policiano
authors.forename: Pedro
authors.initials: P
authors.lastname: Rocha
authors.forename: Maria C
authors.initials: MC
authors.lastname: Catanho
authors.forename: Luísa
authors.initials: L
authors.lastname: Pinto
authors.forename: Alexandre
authors.initials: A
authors.lastname: Valentim-Lourenço
authors.forename: Luís M
authors.initials: LM
authors.lastname: Graça
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D015148:Cardiotocography; D002585:Cesarean Section; D005260:Female; D006465:Hemoperitoneum / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology*; D012422:Rupture, Spontaneous / Q000209:etiology; D013275:Stomach Rupture / Q000209:etiology*
keywords: Bariatric surgery; fasting; metabolic acidosis; pathological cardiotocogram; pregnancy