Document Detail


Pregnancy outcome following non-obstetric surgical intervention.
MedLine Citation:
PMID:  16105538     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the effects of non-obstetric surgical procedures on maternal and fetal outcome. METHODS: A systematic review of all English language literature. RESULTS: Fifty-four papers met the inclusion criteria. The overall number of patients reported was 12,452. Reported maternal death was rare at .006%. The miscarriage rate was 5.8%; however, this number is difficult to interpret since matched controls were not available. The rate of elective termination of pregnancy following non-obstetric surgery was 1.3%. The rate of premature labor induced by non-obstetric surgical intervention was 3.5% and this was noted specifically following appendectomy versus other types of interventions (P<.001). A total of 2.5% of pregnancies resulted in fetal loss. The prematurity rate was 8.2%. The rate of major birth defects among women who underwent non-obstetric surgical intervention in the first trimester was 3.9%. Sub-analysis of papers reporting on appendectomy during pregnancy revealed a high rate (4.6%) of surgery-induced labor. Fetal loss associated with appendectomy was 2.6%; however, this rate was increased when peritonitis was present (10.9%). CONCLUSIONS: Modern surgical and anesthesia techniques appear to diminish the rate of maternal death. Surgery in the first trimester does not appear to increase major birth defects and should not be delayed when indicated. Acute appendicitis with peritonitis is associated with higher risk to the mother and fetus.
Authors:
Raanan Cohen-Kerem; Craig Railton; Dana Oren; Michael Lishner; Gideon Koren
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of surgery     Volume:  190     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-08-17     Completed Date:  2005-09-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  467-73     Citation Subset:  AIM; IM    
Affiliation:
Motherisk Program, Division of Clinical Pharmacology and Toxicology, Department of Pediatrics, University of Toronto, Hospital for Sick Children, Toronto, Ontario, Canada M5G 1X8.
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MeSH Terms
Descriptor/Qualifier:
Appendectomy / adverse effects
Congenital Abnormalities / epidemiology
Female
Humans
Maternal Mortality
Pregnancy
Pregnancy Complications / mortality,  surgery*
Pregnancy Outcome*
Risk
Surgical Procedures, Operative / adverse effects*,  mortality

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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