Perioperative management of surgical procedure during pregnancy: a systematic review

Abstract

Background: Approximately 1-2% of pregnant women undergo non-obstetric surgery under anesthesia during their pregnancy. This review specifically targets anesthesia management for pregnant women undergoing non-obstetric surgery in resource-limited settings. Methods: Following the delineation of primary questions, scope, and inclusion criteria, a comprehensive search strategy utilizing advanced techniques was implemented across electronic sources, databases, and websites to identify relevant articles. A rigorous screening process was applied during literature evaluation. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement guided the conduct of this review, ensuring adherence to standardized reporting practices. Results: A total of 240 articles were initially identified from databases and websites. After screening titles and abstracts, 85 papers were excluded, and an additional 43 were removed due to duplication. Subsequently, 68 items were subjected to eligibility screening. Finally, 30 papers that specifically addressed anesthetic considerations for pregnant women undergoing non-obstetric operations were reviewed. Conclusion: Thorough preoperative evaluation is essential for all patients, with particular attention to modifications in anesthetic management to accommodate physiological changes during pregnancy. Urgent and emergent surgeries should proceed promptly during pregnancy to optimize outcomes for both the mother and fetus. Maintaining uteroplacental perfusion generally involves avoiding maternal hypoxemia, hypotension, hyper- and hypocapnia, temperature extremes, and stress. When deemed safe, regional anesthesia may offer favorable outcomes for both the mother and fetus.