Pneumoamnion and pregnancy loss after second-trimester laparoscopic surgery

Area of Science:

• Minimally invasive surgery
• Obstetrics and Gynecology
• Surgical safety

Background:

• Laparoscopic surgery during the second trimester of pregnancy is generally considered safe.
• However, potential maternal and fetal complications exist.
• This case highlights a rare but severe adverse event.

Observation:

• A 21-week pregnant patient presented with severe abdominal pain.
• Initial laparoscopy revealed normal appendix and pelvic anatomy.
• A subsequent laparoscopic evaluation identified a uterine serosal defect, likely from Veress needle injury.

Findings:

• Pneumoamnion, the presence of air in the amniotic sac, was diagnosed via CT scan.
• The patient experienced spontaneous rupture of membranes and preterm labor.
• This resulted in the delivery of a stillborn fetus.

Implications:

• Inadvertent Veress needle introduction into the gravid uterus is a catastrophic complication.
• This underscores the critical need for meticulous technique in laparoscopic procedures during pregnancy.
• Enhanced vigilance and anatomical awareness are paramount to prevent fetal and maternal morbidity.