Avoidable general anesthesia for nonobstetric surgery during pregnancy: a retrospective cohort pilot study...

About 2% of pregnant women are exposed to general anesthesia for nonobstetric surgery. Given the possibility of adverse fetal and maternal effects associated with exposure to general anesthesia, we sought to evaluate the proportion of cases where general anesthesia could have been avoided.

This single-center pilot retrospective analysis of nonobstetric surgeries performed during pregnancy was conducted at the Caen Normandy University Hospital (2011-2020). An expert panel of seven French anesthesiologists, obstetricians determined whether general anesthesia was avoidable versus required through a majority vote based on an anonymous standardized data collection sheet. General anesthesia was considered avoidable when an alternative such as neuraxial/regional anesthesia or sedation could have been performed.

General anesthesia was avoidable in 36/106 (34%) cases of nonobstetric surgery during pregnancy. Endoscopic JJ ureteral stent insertion or removal was the most common procedure where GA was considered avoidable (19/21 cases; 90%). The consensus rates within the expert panel were of 78% for general anesthesia requirement and 71% for general anesthesia avoidability (P=0.7) CONCLUSIONS: A retrospective review of cases by an expert panel identified that general anesthesia for nonobstetric surgery during pregnancy was likely avoidable in one-third of all cases.