The American College of Obstetricians and Gynecologists in February
2011 documented committee opinion on nonobstetric surgery during pregnancy. Nonobstetric surgery during pregnancy is a
concern for all the providers involved, including anesthesiologists,
obstetricians, surgeons and pediatricians.
In practice, it is a multi-disciplinary team approach in caring for the
woman and fetus. The team can decide the
optimal time to proceed with surgery following the guidelines documented by
committee opinion that a pregnant woman should never be denied surgery
regardless of trimester, nonurgent surgery should be performed in the second
trimester when spontaneous abortion and preterm complications are least likely,
and elective surgery should be performed after delivery.
As an anesthesiologist I take
comfort in the generalization stated in this committee opinion that no
currently used anesthetic agents have been shown to have any teratogenic
effects in humans when using standard concentrations at any gestational
age. It is important to note that there
is difficulty in conducting clinical trials in this patient population; therefore
data is limited to support this.
Possibly further studies would give us more insight into anesthesia and
teratogenicity. In summation, this committee
opinion along with a team approach can help direct our care for nonobstetric
surgery during pregnancy.
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