Non-gynecologic laparoscopy in second and third trimester pregnancy: obstetric implications

Area of Science:

• Obstetrics and Gynecology
• Minimally Invasive Surgery
• Maternal-Fetal Medicine

Background:

• Non-gynecologic surgical conditions requiring intervention during pregnancy pose unique challenges.
• Laparoscopic surgery offers potential benefits over open procedures, including reduced recovery time and smaller incisions.
• The safety and impact of laparoscopic procedures on pregnancy outcomes in the second and third trimesters require careful evaluation.

Purpose of the Study:

• To assess the safety and pregnancy outcomes of non-gynecologic laparoscopic procedures performed during the second and third trimesters of pregnancy.
• To determine if laparoscopic surgery in pregnant patients leads to adverse effects on fetal development or delivery.

Main Methods:

• A retrospective review of patient logs from an antenatal obstetrical unit (January 1, 1997 - December 31, 1997).
• Analysis of medical records to identify gestational age at surgery and delivery, delivery type, tocolysis use, and surgical complications.
• Inclusion criteria focused on non-gynecologic laparoscopic surgeries performed without conversion to laparotomy.

Main Results:

• Nine patients underwent non-gynecologic laparoscopic surgery during the second or third trimester.
• The median gestational age at surgery was 25 weeks; the most common procedure was laparoscopic cholecystectomy (6 patients).
• All deliveries occurred at or after 37 weeks gestation, with no neonatal intensive care unit admissions.

Conclusions:

• Laparoscopic procedures are deemed safe for pregnant patients in the second and third trimesters.
• Laparoscopic cholecystectomies performed as late as 34 weeks gestation did not adversely affect pregnancy outcomes in this series.