Anesthesia for Nonobstetric Surgery in Pregnancy

Ramírez, Mauricio Vasco; G, Catalina M. Valencia

doi:10.1097/grf.0000000000000532

Cited by 24 publications

(30 citation statements)

References 40 publications

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“…Related studies demonstrated that general anesthesia serve better anesthetic effect with similar rate of abortion, premature birth, birth defect and fetal asphyxia. 38 Our results also support the safety of general anesthesia and no anesthesia related complications were reported. As far as pneumoperitoneum is considered, it may, theoretically, increase the intrabdominal pressure and reduce cardiac output and therefore may result in hypoxia and hypotension.…”

Section: Discussionsupporting

confidence: 84%

Laparoscopic Versus Open Appendectomy for Appendicitis in Pregnancy: Systematic Review and Meta-Analysis

Zeng

Aierken

et al. 2021

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Objectives: The clinical safety, efficacy and feasibility of laparoscopic appendectomy (LA) compared with open appendectomy (OA) in pregnancy are still controversial. Herein, we are aiming to compare the clinical outcomes of LA and OA in patients with acute appendicitis during their pregnancy.Materials and Methods: This was a systematic review and metaanalysis of studies comparing laparoscopic and OA in pregnancy identifying using PubMed, Web of science, Embase, The Cochrane Library, Ovid and Scopus. Two independent reviewers extracted data on surgical complication, fetal loss, preterm delivery, hospital stay, Apgar score in both groups.Results: Twenty-seven studies with total of 6497 patients (4464 in open and 2031 in laparoscopic group) were included. LA was associated with lower rate of wound infection [odds risk (OR) = 3.13, 95% confidence interval (CI): 1.77-5.56, P < 0.0001] overall complications (OR = 2.15, 95% CI: 1.47-3.14, P < 0.0001) and shorter hospitalization (mean difference = 0.72, 95% CI: 0.43-1.02, P < 0.00001) compared with open group. LA was in a lower risk for 5-minute Apgar score (mean difference = 0.09, 95% CI: 0.02-0.17, P = 0.01) group than open group. No difference was found regarding preterm delivery between 2 groups. LA was associated with higher fetal loss (OR = 0.57, 95% CI: 0.41-0.79, P = 0.0007) compared with open surgery. However, laparoscopy was not associated with increased fetal loss after 2010 (OR = 0.74, 95% CI: 0.44-1.24, P = 0.26) compared with open group.Conclusions: LA in pregnancy seems to be feasible with acceptable outcome, especially in patients with early and mid-trimester period, with sophisticated hands and experienced centers.

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Section: Discussionsupporting

confidence: 84%

Laparoscopic Versus Open Appendectomy for Appendicitis in Pregnancy: Systematic Review and Meta-Analysis

Zeng

Aierken

et al. 2021

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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“…Vujic et al concluded that non-obstetric surgery during pregnancy could be carried out safely without obstetrical complications [ 21 ]. A recent review demonstrated that anesthetic agents commonly used during pregnancy were not associated with teratogenic effects in clinical doses [ 22 ]. However, ART-DP procedures might be related to ongoing pregnancy outcomes in terms of longer operation time and more blood loss compared with other surgeries performed during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Fetal biometric and Doppler measurements following abdominal radical trachelectomy in the second trimester of the pregnancy

Shima

Itsukaichi

Yoshihara

et al. 2022

BMC Pregnancy Childbirth

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Background Our previous study demonstrated the safety and effectiveness of abdominal radical trachelectomy during pregnancy but did not focus on the fetus. This study aimed to clarify the influence of abdominal radical trachelectomy performed during pregnancy on the fetus. Methods Eight cervical cancer patients who underwent abdominal radical trachelectomy at our hospital between February 2013 and August 2020 were enrolled in this study. To assess the peri- and postoperative influence on the fetus, we performed fetal heart monitoring at 30-min intervals during abdominal radical trachelectomy and calculated the estimated fetal body weight and resistance indexes of the middle cerebral artery and umbilical artery from postsurgery until delivery. Results Four out of eight patients had preterm birth due to chorioamnionitis in one case and consideration of the recurrent risk of cervical cancer in three cases. Fetal heart monitoring during abdominal radical trachelectomy revealed deceleration just once in one case but no abnormal findings in the other cases. In all cases, the fetal growth after abdominal radical trachelectomy was normal until delivery. No abnormal Doppler findings were detected in the middle cerebral artery or umbilical artery. Conclusion Our findings clarified that abdominal radical trachelectomy performed for the treatment of early-stage cervical cancer during pregnancy has no obvious influence on fetal growth. Next, it is necessary to evaluate the growth and development of children delivered from mothers who have undergone abdominal radical trachelectomy during pregnancy.

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“…El diagnóstico de STFF puede pasar desapercibido a lo largo del primer trimestre de la gestación, en virtud del pobre desempeño que ofrecen los marcadores tempranos de compromiso fetal (28), aspecto que explica, en parte, por qué la mayoría de los casos se detectan durante el segundo trimestre y en estadios avanzados de la enfermedad (II y III de Quintero) (1), requiriendo la realización de un procedimiento de emergencia (11,25). En concordancia con lo documentado en otros estudios, la técnica neuroaxial representa el abordaje predilecto para este tipo de pacientes (2,14,17,21,23,(29)(30)(31), dejando como alternativa para casos selectos el uso de la anestesia general con intubación orotraqueal (14,17,21). El motivo para esta elección probablemente radica en que el uso de la técnica neuroaxial se encuentra vinculado con un menor compromiso en la presión de perfusión úteroplacentaria en comparación con la anestesia general (22).…”

Section: Discussionunclassified

Seguridad de la anestesia neuroaxial en mujeres con embarazo gemelar y síndrome de transfusión feto-fetal, sometidas a fotocoagulación láser. Estudio de cohorte retrospectiva

Laverde-Martínez

Zamudio-Castilla

Arango

et al. 2021

Rev. Colomb. Obstet. Ginecol.

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Objetivo: describir las características clínicas y la frecuencia de complicaciones maternas, fetales y neonatales, según técnica de anestesia neuroaxial (AN) en mujeres con síndrome de transfusión feto-fetal (STFF) tratadas con fotocoagulación láser (FL). Materiales y métodos: estudio de cohorte retrospectiva descriptivo. Se incluyeron gestantes con STFF tratadas con FL y AN en la Fundación Valle del Lili, Cali (Colombia) entre 2013-2017. Se excluyeron pacientes con STFF estadio-V de Quintero. Se usó estadística descriptiva. El protocolo fue aprobado por el Comité de Ética de la institución. Resultados: 32 participantes cumplieron con los criterios de inclusión y de exclusión. La población estuvo constituida por mujeres jóvenes, multíparas. En el 87,5% de los casos se realizó intervención de urgencia. El 43,7% presentaba el estadio-III de Quintero y en el 56,2 % de las gestantes se utilizó anestesia epidural. Las variables hemodinámicas maternas exhibieron un comportamiento similar, acorde al momento de la cirugía y la técnica neuoraxial implementada. El 65,6 % de las gestantes presentó hipotensión sostenida y el 9,3 % desarrolló edema pulmonar. El 65,6 % de las pacientes experimentó parto pretérmino y el 18,7 % ruptura prematura de membranas. Se registraron 14 muertes fetales y cinco neonatales. No se registraron casos de mortalidad materna. Conclusiones: en pacientes con STFF que requieren FL, el uso de la anestesia epidural, espinal o combinada probablemente se asocia con un comportamiento similar al de las variables hemodinámicas maternas, durante los momentos de la cirugía. Los profesionales que brindan atención a estas gestantes deben estar alerta ante la frecuente aparición de complicaciones maternas, fetales y neonatales. Se requieren estudios que evalúen la seguridad y la efectividad de las diferentes técnicas de anestesia neuroaxial en pacientes con STFF.

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Anesthesia for Nonobstetric Surgery in Pregnancy

Cited by 24 publications

References 40 publications

Laparoscopic Versus Open Appendectomy for Appendicitis in Pregnancy: Systematic Review and Meta-Analysis

Laparoscopic Versus Open Appendectomy for Appendicitis in Pregnancy: Systematic Review and Meta-Analysis

Fetal biometric and Doppler measurements following abdominal radical trachelectomy in the second trimester of the pregnancy

Seguridad de la anestesia neuroaxial en mujeres con embarazo gemelar y síndrome de transfusión feto-fetal, sometidas a fotocoagulación láser. Estudio de cohorte retrospectiva

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