O&G Cases · Antenatal care — pregnancy after bariatric surgery
Acute abdomen in pregnancy after gastric bypass — emergency management station
Team-based emergency station: suspected internal hernia with small bowel obstruction in the third trimester after Roux-en-Y bypass. Tests parallel maternal resuscitation, the surgical differential, imaging strategy, the operative decision, closed-loop communication with the bariatric surgeon and anaesthetist, and fetal monitoring. Includes assessor key and marking domains.
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Station brief
Format. Emergency management station, approximately 12 minutes. You are the obstetric registrar in the maternity assessment unit. The bariatric surgeon is in theatre and has been called; the anaesthetist is available. The assessor will run the clock and feed you new observations. [1]
Candidate instruction. Lead the management of suspected internal hernia in a third-trimester post-bypass woman. Verbalise your resuscitation, your differential and the diagnosis you must not miss, your imaging strategy, your communication with the surgical and anaesthetic teams, and your fetal monitoring. [2]
References4ShowHide
- [1]Deleus E, Van Den Bosch J, Benhalima K, et al. Laparoscopy is preferred for small bowel obstruction in pregnancy after Roux-en-Y gastric bypass: a 10-year, single center study of 32 cases Surg Endosc, 2026.PMID 41545572
- [2]Skulimowska K, Tomkalski T, Góral A, et al. Care of Patients After Bariatric Surgery in the Periconceptional and Perinatal Periods Nutrients, 2026.PMID 42075092
- [3]Galazis N, Docheva N, Simillis C, et al. Maternal and neonatal outcomes in women undergoing bariatric surgery: a systematic review and meta-analysis Eur J Obstet Gynecol Reprod Biol, 2014.PMID 25126981
- [4]Stopp T, Falcone V, Feichtinger M, et al. Fertility, Pregnancy and Lactation After Bariatric Surgery - a Consensus Statement from the OEGGG Geburtshilfe Frauenheilkd, 2018.PMID 30655646