Severe obesity among adolescents (BMI >=120% of the 95the percentile or BMI >= 35kg/m2)
continues to increase. Metabolic and bariatric surgery (MBS) is a safe and effective
treatment for adolescents; resulting in durable weight loss and resolution of related
comorbidities. Avoiding pregnancy for 18-24 months after MBS is recommended; but teens
face challenges concerning pregnancy prevention. Rapid weight loss after MBS improves
polycystic ovarian syndrome and anovulation; leading to increases in fertility. Teens
commonly use contraceptive methods with higher failure rates; this coupled with the
increased risk of oral contraception failure after MBS, may lead to unplanned pregnancies.
In fact, adolescent pregnancy rates after MBS are two-fold higher compared to the
general adolescent population (12.8% vs 6.4%). Long acting reversible contraception
(LARC) methods are safe and highly effective, making them a top tier choice for teens.
Using quality improvement (QI) methodology, we aimed to increase levonorgestrel intrauterine
device (LNG-IUD) insertion at the time of MBS in females receiving care at a single
tertiary children’s hospital.
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