There are many risks and benefits associated with surgery during pregnancy. Among the most common risks is preterm delivery, but there are also other important reasons to choose another time. While elective surgery is often more beneficial in the second or third trimester, emergency surgeries should be avoided at all costs. First trimester surgery carries the highest risks of spontaneous abortion and teratogenicity, and third trimester surgery has the highest risk of preterm labor.
One major risk of surgery during pregnancy is increased risk to the unborn child. The best way to minimize the risks associated with pregnancy and surgical procedures is to wait until the second trimester. Although it is not ideal to undergo surgery during pregnancy, there are many ways to minimize the risks associated with the procedure. The first step is to make sure that you are not pregnant. If you have had a negative pregnancy test, you can request a pregnancy test before your procedure.
Physiologic changes during pregnancy should inform perioperative risks. Fetal concerns can include spontaneous abortion, low birth weight, and intrauterine growth retardation. Your obstetrician should discuss any concerns regarding fetal monitoring. Surgical risks are reduced during labor and delivery when obstetrician staff use standard guidelines for fasting. And for patients who experience complications during pregnancy, fetal heart rate monitoring and the use of X-ray shields can help prevent infection.
Another major concern is fetal risks. Surgery during pregnancy can cause significant harm to the unborn baby. Preterm labor and delivery are the leading causes of fetal death. Fortunately, there are many ways to reduce this risk. It is important to inform pregnant women and their doctors about all risks, particularly those associated with anesthesia. A comprehensive assessment of perioperative risks and complications is essential before any procedure can be scheduled. If possible, discuss all risks and benefits of the procedure beforehand with your surgeon.
Although the risks and benefits of surgery during pregnancy are well documented, most procedures will require a perioperative observation. The risks of delay in diagnosis should be weighed against the potential consequences of a negative laparoscopy. If diagnostic imaging is inconclusive, then a laparoscopy is appropriate. The surgeon should have the knowledge and expertise to treat any conditions found at the laparoscopy. Ultrasound imaging is a safe and effective imaging test during pregnancy.
Fetal monitoring is recommended by the Royal College of Obstetricians and Gynecologists, due to increased malpractice litigation risk. However, the decision to monitor FHR is individualized and dependent on the circumstances of each patient. However, it is important to note that most anaesthetic agents cross the placenta and may affect FHR tracing. Monitoring maternal blood pressure and oxygenation during surgery can alert obstetricians to alterations that affect the fetus.
The two most common non-obstetric surgeries during pregnancy are cholecystectomy and appendectomy. In the United States, laparoscopy is the preferred procedure for this surgical procedure, although data on this procedure are unavailable. Despite this, surgeons must be aware of the evidence-based benefits and risks of each technique. Fortunately, the new guidelines for surgery during pregnancy will help guide them in performing their procedures in a safe and efficient way.