Pregnancy outcomes following nonobstetric surgery during gestation: a nationwide population-based case-control study in Taiwan

Yu, Chia-Hung; Weng, Shih‐Feng; Ho, Chung‐Han; Chen, Yi‐Chen; Chen, Jen-Yin; Chang, Ying-Jen; Wang, Jhi-Joung; Wu, Ming‐Ping; Chu, Chin-Chen

doi:10.1186/s12884-018-2079-4

Cited by 36 publications

(59 citation statements)

References 25 publications

(40 reference statements)

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“…Ibiebele et al showed an equal risk of SGA in laparoscopy and laparotomy, confirming that it is acceptable to combine these procedures when studying the risk of SGA. As in most other studies, we found an increased risk of miscarriage following surgical procedures during pregnancy. Direct comparison of magnitudes of the risk of miscarriage between studies is difficult because of variations in definition of exposure, varying time from exposure and varying completeness of miscarriages.…”

Section: Discussionsupporting

confidence: 89%

“…As in most other studies, 12,13,16,17 we found an increased risk of miscarriage following surgical procedures during pregnancy. Our results should be interpreted while considering some limitations.…”

Section: Discussionsupporting

confidence: 88%

“…Surgical procedures trigger both inflammatory and microbial responses, which may affect the fetus and timing of birth . The risk of adverse birth outcomes after surgery during pregnancy has been the topic of several studies . A systematic review of the literature until 2002 including 54 studies and 4473 women concluded that non‐obstetric surgery was probably not a risk factor for miscarriage .…”

Section: Introductionmentioning

confidence: 99%

“…Still, the authors underscored a need for better data and well‐designed studies in this area . At least 5 larger studies have since then examined non‐obstetric surgery during pregnancy . In general, these studies found an increased risk of adverse pregnancy outcomes, but Balinskaite et al concluded that the attributable risk was low .…”

Section: Introductionmentioning

confidence: 99%

“…12 At least 5 larger studies have since then examined non-obstetric surgery during pregnancy. [10][11][12][13][14] In general, these studies found an increased risk of adverse pregnancy outcomes, but Balinskaite et al concluded that the attributable risk was low. 12 Only Ibiebele et al took gestational age (GA) at time of surgery into account in their analyses and found an increased risk of preterm birth.…”

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confidence: 99%

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Non‐obstetric abdominal surgery during pregnancy and birth outcomes: A Danish registry‐based cohort study

Rasmussen

Christiansen

Ulrichsen

et al. 2019

Acta Obstet Gynecol Scand

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Introduction Surgery during pregnancy may increase the risk of adverse birth outcomes. In this nationwide registry‐based cohort study including women aged 15‐54 years with singleton birth or miscarriage, we examined the association between non‐obstetric abdominal surgery during pregnancy and the birth outcomes small‐for‐gestational‐age (SGA), preterm birth, and miscarriage. Material and methods The study used data on births or miscarriages from the large national Danish registries in 1997‐2015. We calculated absolute risks and risk differences for the main outcomes and used Cox regression analysis with non‐obstetric abdominal surgery as a time‐varying exposure, adjusting for maternal age, year of last menstrual period, major abdominal surgery before pregnancy, maternal smoking status, rheumatoid arthritis, diabetes and inflammatory bowel disease. Our main outcome measures were risks and hazard ratios (HRs) for SGA, very preterm or preterm birth, and miscarriage after gestational week 7 overall, stratified by calendar year, and, for SGA, trimester of pregnancy. Finally, absolute risk of miscarriage stratified by time since surgery. Results Absolute risks in surgically treated vs untreated were 3.4% vs 2.7% for SGA (adjusted HR 1.3, 95% CI 1.1‐1.5), 2.2% vs 0.8% for very preterm birth (adjusted HR 2.8, 95% CI 2.2‐3.5), 8.3% vs 4.3% for preterm birth (adjusted HR 2.1, 95% CI 1.9‐2.3), and 8.2% vs 6.1% for miscarriage (adjusted HR 3.1, 95% CI 2.7‐3.5). For miscarriage, the risk was highest the first week after surgery and levelled out after 2 weeks. Conclusions Surgery during pregnancy is associated with an increased risk of SGA, very preterm birth, preterm birth and miscarriage, and the risk of miscarriage is highest the first week after surgery.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Non‐obstetric abdominal surgery during pregnancy and birth outcomes: A Danish registry‐based cohort study

Rasmussen

Christiansen

Ulrichsen

et al. 2019

Acta Obstet Gynecol Scand

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Surgical Management of Airway Stenosis During Pregnancy: A Scoping Review

Miller,

Liang,

Nero

et al. 2023

The Laryngoscope

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ObjectiveThere are several options for surgical management of subglottic stenosis, including endoscopic and open procedures. However, treatment algorithms, outcomes, and anesthetic management of subglottic stenosis during pregnancy are not well described.Data SourcesMEDLINE, EMBASE, and the Cochrane databases.Review MethodsA scoping review of management of subglottic stenosis during pregnancy was performed, and then reported in compliance with Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Inclusion criteria consisted of those with subglottic or tracheal stenosis aged greater than 18 years, those in whom management was performed during pregnancy, and those who reported delivery related outcomes.ResultsAfter systematic review and detailed search of 330 identified articles, 15 articles met inclusion criteria and were included in the final analysis. All studies were case reports or case series (level 4 evidence). This study identified 27 patients. The median age was 29 and the median gestational age at intervention was 28 weeks. Left lateral positioning and fetal heart rate monitoring were used in nearly every case. The most common intervention performed was endoscopic balloon dilation. In many cases, jet ventilation or transnasal humidified rapid insufflation ventilatory exchange was satisfactory for maintenance of the airway. Three women ultimately required tracheostomy prior to labor and delivery. There was no fetal death or complications reported in these studies, and all but one woman proceeded to deliver at term.ConclusionEndoscopic balloon dilation during pregnancy is safe and effective, resulting in optimized respiratory outcomes for the mother and safe delivery of the fetus. The third trimester appears to be safe for airway intervention. Laryngoscope, 2023

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