Non Obstetric Surgery During Pregnancy 2013

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  Imelda Odibo, MD 2 nd -Year Maternal-Fetal Medicine Fellow Division of Maternal-Fetal Medicine Department of Obstetrics and Gynecology University of Arkansas for Medical Sciences Non-Obstetric Surgery During Pregnancy  Objectives  Describe the role of the obstetrician in the diagnosis and management of patients requiring non-obstetric surgery during pregnancy  Outline common indications for non-obstetric surgery in the parturient  Discuss anesthetic considerations, optimal timing and surgical approach to non-obstetric surgery during pregnancy  Discuss indications for tocolytics, antenatal steroids, progesterone and the guidelines on fetal monitoring when non-obstetric surgery is performed during pregnancy  Discuss effect of anesthesia and surgery on maternal and fetal outcome after non-obstetric surgery  Introduction  Non-obstetric surgery during pregnancy  Performed in 1.5-2% of all pregnancies  More than 75,000 women in the US each year  Diagnosis and management complicated by altered anatomy and physiology  Difficulty of conducting large-scale, randomized clinical trials in this population  Information based on observational studies, expert opinion, and extrapolation from trials in non pregnant individuals  ACOG: Insufficient data to allow for specific recommendations  Role of the Obstetrician  ACOG  Obstetric consultation prior to performing non-obstetric surgery and some invasive procedures (cardiac catheterization, colonoscopy) during pregnancy  Multi-disciplinary approach  Obstetricians uniquely qualified to discuss aspects of maternal physiology and anatomy which may affect maternal-fetal well-being  Obstetrician must be well informed on  Influence of surgical disorders on pregnancy and vice versa  Risk of diagnostic and therapeutic procedures  Management of preterm labor in immediate postoperative period


Jul 23, 2017
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