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Laparoscopic surgery during pregnancy

J D Amos¹, S J Schorr, P F Norman

¹Department of Surgery, University of Mississippi School of Medicine, Jackson, USA.

American Journal of Surgery

|April 1, 1996

Summary

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Laparoscopic surgery using carbon dioxide pneumoperitoneum in pregnant women with appendicitis or cholecystitis resulted in a high rate of fetal death. Caution is advised for non-obstetrical laparoscopic procedures during pregnancy.

Area of Science:

Obstetrics and Gynecology
Surgical Innovation
Fetal Medicine

Background:

Animal studies indicate fetal acidosis during carbon dioxide (CO2) pneumoperitoneum.
This suggests a potential risk to fetal well-being in pregnant humans undergoing CO2 pneumoperitoneum.

Purpose of the Study:

To evaluate the safety and outcomes of laparoscopic surgery with CO2 pneumoperitoneum in pregnant women.
To compare fetal outcomes between pregnant patients undergoing laparoscopic surgery and those undergoing open laparotomy.

Main Methods:

Retrospective review of pregnant patients who underwent laparoscopic surgery for appendicitis or cholecystitis.
Comparison of pregnancy outcomes with a cohort of pregnant patients who underwent formal laparotomy.

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Main Results:

Four fetal deaths occurred among seven pregnant patients who underwent laparoscopic surgery.
In contrast, four of five pregnant patients who underwent laparotomy delivered at term.

Conclusions:

Laparoscopic surgery with CO2 pneumoperitoneum in pregnant women is associated with significant fetal risk.
Further clinical and laboratory research is necessary to assess fetal risks associated with non-obstetrical laparoscopic surgery in pregnancy.