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. 2021 Apr;91(4):627-632.
doi: 10.1111/ans.16617. Epub 2021 Feb 1.

Evaluation of safety and foeto-maternal outcome following non-obstetric surgery in pregnancy: a retrospective single-site Australian study

Ho Nam Choi  1   2 , Bertrand Ren Joon Ng  1   2 , Yasser Arafat  1   2 , Balapuwaduge A S Mendis  2 , Anoj Dharmawardhane  2   3 , Tarana Lucky  4   5
Affiliations

Evaluation of safety and foeto-maternal outcome following non-obstetric surgery in pregnancy: a retrospective single-site Australian study

Ho Nam Choi et al. ANZ J Surg. 2021 Apr.

Abstract

Background: Existing data on safety of non-obstetric surgery during pregnancy appear limited and conflicting. This study aimed to assess perinatal outcomes and complications in pregnant women undergoing non-obstetric surgeries.

Methods: A single-site Australian study was performed utilizing a 10-year data (2009-2018) collected retrospectively. Descriptive statistics were used to summarize the characteristics of the study population. Statistical analyses between groups were conducted by independent t-test or Mann-Whitney (for means between groups) and by chi-squared/Fisher's exact test (for categorical variables).

Results: A total of 108 pregnant women underwent non-obstetric surgery, with an increasing trend in annual numbers since 2014. The majority of women (91%) underwent surgeries as an emergency procedure, and under general anaesthesia (69.8%). Procedures during the first trimester comprised 45%, making it the most common trimester for non-obstetric surgeries. The most common cause for surgery arose in the gastrointestinal/digestive tract (39%). Overall perinatal complication rate was 19% with the rate of miscarriage/foetal loss, preterm birth and intrauterine growth restriction/small for gestational age being 4.7%, 10.4% and 3.8%, respectively. A total of 46 patients underwent intra-abdominal surgery. The most common surgery in the laparoscopy group was appendicectomy (56%), whereas adnexal pathology (54%) contributed to the majority of laparotomies. Subgroup comparison showed no significant difference in perinatal outcomes except for caesarean delivery rate (24% versus 67% for laparoscopy versus open, respectively (P = 0.04)).

Conclusion: With an overall perinatal complication rate of 19%, the rate of adverse perinatal outcomes following non-obstetric surgery during pregnancy in our study was low and comparable to those of the general population.

Keywords: laparoscopy; pregnancy; surgery.

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