Perinatal aspects of abdominal surgery for nonobstetric disease

Surgical interventions for nonobstetric reasons during pregnancy are reported to occur in 0.2% to 2.2% of all gestations with obvious perinatal implications. In this retrospective study, 57 parturients were identified who underwent nonobstetric abdominal surgery. Thirty-one patients underwent exploratory celiotomy for suspected appendicitis, 16 for adnexal disease other than ectopic pregnancy, six for cholecystectomy, three for intestinal disorders, and one with a pheochromocytoma. Alterations in disease expression are related to the severity of the disease and advancing gestational age, being more important in cases of appendicitis. Preterm labor reflecting fetal morbidity relates to the presence of peritonitis and then only during the third trimester. In this retrospective study, tocolysis with intravenous magnesium sulfate had an uncertain effect on the incidence of preterm delivery. Prospective studies will be required to assess the indications and limitations of tocolysis for nonobstetric abdominal surgical conditions.