Objective Nonobstetric surgery occurs in 1–2/1000 pregnancies. Appendectomy and cholecystectomy are the two most common nonobstetric surgeries performed in pregnant women. The objective of this retrospective cohort study was to utilize the data from the American College of Surgeons National Surgical Quality Improvement Program to estimate major postoperative morbidity after 1) appendectomy in pregnant compared with non-pregnant women and 2) cholecystectomy in pregnant compared with non-pregnant women. Methods We selected a cohort of reproductive aged women undergoing appendectomy and cholecystectomy between 2005 and 2009 from the data files of the American College of Surgeons National Surgical Quality Improvement Program. Outcomes in pregnant women were compared to those in non-pregnant women. The primary outcome was composite 30-day major postoperative complications. Pregnancy-specific complications were not assessed and thus not addressed. Results Pregnant and non-pregnant women had similar composite 30-day major morbidity after appendectomy (3.9% vs. 3.1%, p=0.212) and cholecystectomy (1.8% vs. 1.8%, p=0.954). Pregnant women were more likely to have preoperative systemic infections before each procedure. In logistic regression analysis, pregnancy status was not predictive of increased postoperative morbidity for appendectomy (adjusted odds ratio 1.26, 95% confidence interval 0.87–1.82). Conclusion Pregnancy does not increase the occurrence of postoperative maternal morbidity related to appendectomy and cholecystectomy.

Women presenting to the ED postpartum period had a wide variety of medical issues but 78% were not admitted. Given the timing and low acuity of many visits, better postpartum education may be a tool to reduce nonemergent postpartum ED visits.