Preoperative Assessment of the Pregnant Patient Undergoing Nonobstetric Surgery

Webb, Michael P.; Helander, Erik; Meyn, Ashley R.; Flynn, Trevor; Urman, Richard D.; Kaye, Alan D.

doi:10.1016/j.anclin.2018.07.010

Cited by 8 publications

(7 citation statements)

References 37 publications

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“…Increased levels of progesterone and prostaglandins result in maternal mucosal capillary engorgement with a more friable airway ( 24 ), while hemodynamic changes during pregnancy include a 40–50% increase in blood volume and cardiac output and a 20% reduction in hematocrit due to dilution ( 23 ). These changes could result in a bloody, difficult-to-visualize glottis, particularly in the context of instrumentation ( 25 ).…”

Section: Anesthesia and Fetal Management During Surgery In Pregnancy Womenmentioning

confidence: 99%

“…Acid aspiration prophylaxis is recommended to reduce gastric content and increase gastric pH, to reduce morbidity and mortality when accidental aspiration occurs ( 26 ). Prophylaxis of choice should be an H2-receptor antagonist and non-particulate antacid and should be employed after 16 weeks of pregnancy ( 25 ).…”

Section: Anesthesia and Fetal Management During Surgery In Pregnancy Womenmentioning

confidence: 99%

“…Venous thromboembolic (VTE) disease is a major risk in pregnancy and has been shown to complicate 0.5 to 2.2 of every 1,000 pregnancies, especially in postpartum period ( 25 ). Prophylaxis with low molecular weight heparins should be used.…”

Section: Anesthesia and Fetal Management During Surgery In Pregnancy Womenmentioning

confidence: 99%

“…Furthermore, Food and Drugs Administration (FDA) raise concern about inhalational agents and intravenous propofol and midazolam use, the common agents administered during pregnancy for general anesthesia and sedation, for potential risks to fetal development, minimizing fetal exposure to these agents is important and advisable ( 30 ). Also, maternal hypoxemia/hypercapnia and maternal hypotension, that could lead to fetal asphyxia, are possibly related to teratogenic effects ( 25 ). Prolonged or serious maternal hypoxemia causes utero-placental vasoconstriction and reduce the utero-placental perfusion, resulting in fetal hypoxemia, acidosis and, finally, fetal death ( 26 ).…”

Section: Anesthesia and Fetal Management During Surgery In Pregnancy Womenmentioning

confidence: 99%

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Surgery on breast cancer in pregnancy

Liberale¹,

Tripodi²,

Ottino³

et al. 2019

Transl. Cancer Res.

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Pregnancy-associated breast cancer (PABC) is defined as breast cancer develops either during or within 1 year after pregnancy, it is a rare disease arising in 1:3,000 to 1:10,000 pregnant women. Prognosis of this tumor is influenced by local or systemic treatment, which might be conditioned by gestational age and limited by the concern on potential adverse impact on fetus. The aim of this literature review is to analyze the main topics regarding surgical treatment of patients diagnosed with breast cancer in pregnancy: anesthesia and maternal-fetal monitoring, type of breast surgery, immediate breast reconstruction after radical surgery and management of the axilla. Some important topics remain controversial since the relative rarity of PABC precludes the feasibility of large studies leading to a lack of literature data. Multi-institutional collaboration is warranted to collect women with PABC, in order to best define surgical treatment in view of associated maternal and fetal risks.

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Section: Anesthesia and Fetal Management During Surgery In Pregnancy Womenmentioning

confidence: 99%

Section: Anesthesia and Fetal Management During Surgery In Pregnancy Womenmentioning

confidence: 99%

Section: Anesthesia and Fetal Management During Surgery In Pregnancy Womenmentioning

confidence: 99%

Section: Anesthesia and Fetal Management During Surgery In Pregnancy Womenmentioning

confidence: 99%

See 2 more Smart Citations

Surgery on breast cancer in pregnancy

Liberale¹,

Tripodi²,

Ottino³

et al. 2019

Transl. Cancer Res.

View full text Add to dashboard Cite

show abstract

“…Preoperative assessment of obstetrics, women should start with a history of maternal health, anesthetic history, past obstetric history, allergies, family history, history of substance abuse, baseline vital signs, examination of the airway, heart, lungs and lower back [ 2 ].…”

Section: Introductionmentioning

confidence: 99%