Surgical Interventions During Pregnancy
Summary
Pregnancy may coincide with a range of surgical conditions requiring timely intervention for maternal and foetal well-being. Non-obstetric surgery occurs in approximately 0.2–2% of pregnancies, with acute appendicitis, biliary pathology and adnexal masses among the most frequent indications. The choice of operative approach must balance the risk of anaesthesia, foetal exposure and maternal haemodynamic stability, taking into account gestational age. Minimally invasive techniques, notably laparoscopy, have gained prominence for selected procedures, offering reduced postoperative pain and shorter hospitalisation without compromising foetal outcomes. Imaging plays a central role in diagnosis and surgical planning; ultrasonography remains first line, while magnetic resonance imaging provides detailed tissue characterisation without ionising radiation. Multidisciplinary collaboration among obstetricians, surgeons and anaesthetists ensures that perioperative care optimises maternal cardiopulmonary function and minimises uterine irritability. Evidence increasingly supports that with careful patient selection and standardised protocols, surgical interventions during pregnancy can be performed safely, with low rates of miscarriage or teratogenic effects. Research priorities include refining risk stratification tools, standardising laparoscopic technique in later trimesters and improving neonatal follow-up after in utero exposure to anaesthetic agents.
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Surgical Interventions During Pregnancy publication trend
The graph below shows the total number of articles in surgical interventions during pregnancy across all publications each year (not limited to Nature Index journals).
Technical terms
Non-obstetric surgery: Surgical procedures unrelated to obstetric management performed during gestation.
Laparoscopy: Minimally invasive surgery using small incisions and a camera to visualise and treat intra-abdominal conditions.
Ultrasonography: Imaging technique employing high-frequency sound waves to assess soft tissues and foetal structures.
Magnetic resonance imaging (MRI): Imaging modality harnessing magnetic fields and radiofrequency pulses to generate detailed soft tissue contrast without ionising radiation.
Preterm birth: Delivery occurring before 37 completed weeks of gestation, associated with increased neonatal risk.
References
- Imaging of Acute Abdominopelvic Pain in Pregnancy and Puerperium—Part II: Non-Obstetric Complications. Diagnostics (2023).
- Non-obstetric surgery during pregnancy and the effects on maternal and fetal outcomes: A systematic review. Scandinavian Journal of Surgery (2023).
- Laparoscopic appendectomy versus open appendectomy for suspected appendicitis during pregnancy: a systematic review and updated meta-analysis. BMC Surgery (2019).
- Clinical Characteristics of Acute Appendicitis in Pregnancy: 10-Year Experience at a Single Institution in South Korea. Journal of Clinical Medicine (2023).
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