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Original Article

Perioperative management and pregnancy outcome analysis for non-obstetric surgery during pregnancy: 87 case series

  • Yafen Wu ,
  • Peng Tuo ,
  • Jinfa Liu ,
  • Shouping Wang
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  • 1. Department of Anesthesiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Guangdong 510150, China
Corresponding author: Wang Shouping, Email:

Received date: 2019-07-01

  Online published: 2020-02-18

Abstract

Objective

To investigate anesthesia methods, operation factors and infection factors effect on maternal and fetal outcome during non-obstetric surgery.

Methods

The clinical data of 87 pregnant women who needed surgical treatments for non-obstetric diseases from January 2015 to August 2018 in The Third Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. We documented their pregnancy outcome indexes such as gestational week, mode of delivery and premature birth rate. Then, the effects of different pregnancies, surgical methods, anesthetic methods and complications of infection on pregnant women′s were compared.

Results

There are 35 cases of acute appendicitis (40.2%), 7 cases of uterine pregnancy complicated with ectopic pregnancy (8.1%), 9 cases of ovarian cyst pedicle torsion (10.3%), 21 cases of ovarian mass (24.1%), 13 cases of Urinary calculi (14.9%) and 2 cases of cholecystolithiasis (2.3%). There were no significant differences in pregnancy outcome among pregnant women undergoing non-obstetric surgery during different pregnancies (P>0.05). There were no significant differences in mode of delivery, gestational age, abortion rate and premature delivery rate between laparoscopy group and abdomen group (P>0.05). There were no significant differences in mode of delivery, gestational age, premature delivery rate and abortion rate between intravertebral anesthesia group and general anesthesia group (P>0.05). The pregnant women with infection had an effect on the pregnancy outcome. The gestational age of the infected group was lower than that of the control group [(34.7±0.7) weeks vs (38.5±0.2) weeks, Z=5.088, P<0.05]. The incident rate of cesarean section, premature delivery and abortion in the infection group were all higher than those in the control group [41.7% (10/24) vs 31.7% (20/63), χ2=7.585; 50% (12/24) vs 7.9% (5/63), χ2=19.588; 50.0% (12/24) vs 0, χ2=29.659; all P<0.05].

Conclusions

Non-obstetric surgery during pregnancy still can achieve satisfactory pregnancy outcome in the stable patients, while different kind of anesthesia and operation in different gestation will not affect the safety of the puerperant and fetus, but the progress of the disease itself may affect the pregnancy outcome for the co-infection patient.

Cite this article

Yafen Wu , Peng Tuo , Jinfa Liu , Shouping Wang . Perioperative management and pregnancy outcome analysis for non-obstetric surgery during pregnancy: 87 case series[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2020 , 09(01) : 54 -58 . DOI: 10.3877/cma.j.issn.2095-3259.2020.01.012

References

[1]
Reitman E, Flood P. Anaesthetic considerations for non-obstetric surgery during pregnancy[J]. Br J Anaesth, 2011, 107(1): 72-78.
[2]
Upadya M, Saneesh PJ. Saneesh, Anaesthesia for non-obstetric surgery during pregnancy [J]. Indian J Anaesth, 2016, 60(4): 234-241.
[3]
Bone RC, Balk RA, Cerra FB, et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine[J]. Chest, 1992, 101(6): 1644-1655.
[4]
Cox TC, Huntington CR, Blair LJ, et al. Laparoscopic appendectomy and cholecystectomy versus open: a study in 1999 pregnant patients [J]. Surg Endosc, 2016, 30(2): 593-602.
[5]
Laustsen JF, Bjerring OS, Johannessen ?,et al. Laparoscopic appendectomy during pregnancy is safe for both the mother and the fetus[J]. Dan Med J, 2016, 63: A5259.
[6]
Pearl J, Price R, Richardson W, et al.Society of American Gastrointestinal Endoscopic Surgeons. Guidelines for diagnosis, treatment, and use of laparoscopy for surgical problems during pregnancy [J]. Surg Endosc, 2011, 25(11): 3479-3492.
[7]
Baldwin EA, Borowski KS, Brost BC,et al. Antepartum nonobstetrical surgery at ≥23 weeks′ gestation and risk for preterm delivery[J]. Am J Obstet Gynecol, 2015, 212(2): 232-235.
[8]
Cohen-Kerem R, Railton C, Oren D,et al. Pregnancy outcome following non-obstetric surgical intervention [J]. Am J Surg,2005,190(3): 467-473.
[9]
Ravindra GL, Madamangalam AS, Seetharamaiah S. Anaesthesia for non-obstetric surgery in obstetric patients [J]. Indian J Anaesth, 2018, 62(9):710-716.
[10]
曲元,黄宇光. 妇产科麻醉[M]. 2版. 北京:北京大学医学出版社,2018: 163-167.
[11]
Theilen LH, Mellnick VM, Shanks AL,et al.Acute Appendicitis in Pregnancy: Predictive Clinical Factors and Pregnancy Outcomes[J]. Am J Perinatol, 2017, 34(6): 523-528.
[12]
Abbasi N, Patenaude V, Abenhaim HA. Evaluation of obstetrical and fetal outcomes in pregnancies complicated by acute appendicitis[J]. Arch Gynecol Obstet,2014,290(4):661-667.
[13]
Kuczkowski, KM, The safety of anaesthetics in pregnant women[J]. Expert Opin Drug Saf, 2006, 5(2): 251-264.
[14]
Bonnet MP. Sedation and anaesthesia for non-obstetric surgery [J]. Anaesth Crit Care Pain Med, 2016, 35(1): 35-41.
[15]
Shetti AN, Dhulkhed VK, Gujarati A, et al. Anesthetic management of a pregnant patient with pseudo-pancreatic cyst for cysto-gastrostomy [J]. Anesth Essays Res,2014,8(1): 89-92.
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