American Journal of Obstetrics and Gynecology
ResearchObstetricsAntepartum nonobstetrical surgery at ≥23 weeks’ gestation and risk for preterm delivery
Section snippets
Materials and Methods
The Mayo Clinic Department of Obstetrics electronic database was reviewed to identify all patients undergoing a surgical procedure within 12 months of a documented pregnancy and/or delivery from January 1992 through March 2014. For study purposes, a GA of ≥23 weeks’ gestation was considered to represent the threshold of fetal viability in our institution. Each electronic medical record identified was reviewed to confirm an antepartum surgical procedure was performed, and then abstracted for
Results
During the 23-year study interval, approximately 36,100 patients were delivered at the Mayo Clinic in Rochester, MN. A total of 121 surgical procedures were performed in 111 patients at ≥23 weeks’ gestation, for an incidence of approximately 1 procedure per 325 pregnancies. Singleton gestations comprised 108 of the 111 pregnancies, with 3 twin pregnancies included. Multiple procedures were required in 8 patients during a single pregnancy, 5 of which were performed for recurrent urologic
Comment
Surgical procedures performed at or beyond fetal viability pose a relatively low risk of intraoperative or immediate postoperative obstetrical complications but appear to confer an increased risk of eventual preterm delivery. Study findings included 10% of patients undergoing nonobstetric surgery delivering within 1 week and 41% <37 weeks’ gestation, with a single recorded instance of possible intraoperative fetal demise. Subgroup analysis by procedural type and GA at time of surgery did not
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Cited by (18)
Surgical emergencies in the pregnant patient
2023, Current Problems in SurgeryIntracranial surgery
2023, The Brain of the Critically Ill Pregnant WomanIntraoperative fetal heart monitoring for non-obstetric surgery: A systematic review
2019, European Journal of Obstetrics and Gynecology and Reproductive BiologyCitation Excerpt :Eighty-nine (74.2%) reported about iFHRM during non-obstetric surgery, and 50 (56.2%) reported specific information on iFHRM. Four (3.3% of the total) [17–20] were case series including ≥5 cases with details of iFHRM during non-obstetric surgery performed at ≥22weeks. The quality of the studies included in our review was assessed by the Methodological Index for Non-Randomized Studies’ tool [14] for assessment of the risk of bias (Fig. 2).
Caring for Pregnant Patients Undergoing Nonobstetric Surgery
2023, AORN JournalGeneral anesthesia for maternal surgery during pregnancy: dogmas, myths and evidence, a narrative review
2024, Acta Anaesthesiologica Belgica
The authors report no conflict of interest.
Cite this article as: Baldwin EA, Borowski KS, Brost BC, et al. Antepartum nonobstetrical surgery at ≥23 weeks’ gestation and risk for preterm delivery. Am J Obstet Gynecol 2015;212:232.e1-5.