Bariatric surgery and adolescent gynecology

被引:5
作者
Miller, Rachel J.
Xanthakos, Stavra A.
Hillard, Paula J. Adams
Inge, Thomas H.
机构
[1] Childrens Hosp, Med Ctr, Div Adolescent Med, Cincinnati, OH 45229 USA
[2] Childrens Hosp, Med Ctr, Dept Pediat, Cincinnati, OH 45229 USA
[3] Stanford Univ, Med Ctr, Div Gynecol Specialties, Dept Obstet & Gynecol, Stanford, CA 94305 USA
[4] Cincinnati Childrens Hosp, Med Ctr, Dept Surg, Cincinnati, OH USA
关键词
anovulation; bariatric surgery; contraception; obesity; PCOS;
D O I
10.1097/GCO.0b013e3282efb285
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Purpose of review This review summarizes the impact of bariatric surgery on gynecologic complications in the context of the extremely obese adolescent and reviews contraceptive considerations before and after adolescent bariatric surgery. Recent findings Eighteen percent of children and adolescents have a body mass index greater than the 95th percentile, with 4% of adolescents being greater than the 99th percentile. Gynecologic morbidities identified in obese adolescents include anovulatory complications such as acute, menorrhagia, polycystic ovary syndrome and endometrial hyperplasia, and cancer. When conventional dietary and behavioral therapy fail to result in weight loss, specific criteria have been identified to justify bariatric surgery in extremely obese adolescents. Bariatric surgery in adult women often results in resumption of ovulatory menses, resolution of clinical and laboratory evidence of hyperandrogenism, and return of fertility. Adolescents are at risk for unintended pregnancies, and there are special concerns regarding pregnancy in bariatric patients. Specific contraceptive methods have particular potential risks, benefits, and drawbacks for use in obese adolescents. Summary Clinicians who provide care for extremely obese adolescents must be aware of the potential for gynecologic morbidities including polycystic ovary syndrome, dysfunctional bleeding and endometrial hyperplasia, expected gynecologic and fertility outcomes of weight loss surgery for teens, as well as the implications on contraceptive options.
引用
收藏
页码:427 / 433
页数:7
相关论文
共 60 条
[1]  
*ACOG, 2005, OBSTET GYNECOL, V106, P671, DOI DOI 10.1097/00006250-200509000-00054
[2]  
[Anonymous], 2001, INT J GYNECOL OBSTET, V72, P263
[3]  
[Anonymous], 1992, AM J CLIN NUTR S, V55, p487S
[4]  
[Anonymous], SEER CANC STAT REV
[5]   The prevalence and features of the polycystic ovary syndrome in an unselected population [J].
Azziz, R ;
Woods, KS ;
Reyna, R ;
Key, TJ ;
Knochenhauer, ES ;
Yildiz, BO .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2004, 89 (06) :2745-2749
[6]  
*BERL INC, 2006, MIRENA PACK INS
[7]   Weight gain in obese and nonobese adolescent girls initiating depot medroxyprogesterone, oral contraceptive pills, or no hormonal contraceptive method [J].
Bonny, AE ;
Ziegler, J ;
Harvey, R ;
Debanne, SM ;
Secic, M ;
Cromer, BA .
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE, 2006, 160 (01) :40-45
[8]   Bariatric surgery: A systematic review and meta-analysis [J].
Buchwald, H ;
Avidor, Y ;
Braunwald, E ;
Jensen, MD ;
Pories, W ;
Fahrbach, K ;
Schoelles, K .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 292 (14) :1724-1737
[9]   Body-mass index and mortality in a prospective cohort of US adults [J].
Calle, EE ;
Thun, MJ ;
Petrelli, JM ;
Rodriguez, C ;
Heath, CW .
NEW ENGLAND JOURNAL OF MEDICINE, 1999, 341 (15) :1097-1105
[10]   The levonorgestrel intrauterine system: the benefits of reduced bleeding [J].
Cameron, IT .
EUROPEAN JOURNAL OF CONTRACEPTION AND REPRODUCTIVE HEALTH CARE, 2001, 6 :27-32