Abstract
Surgery may be necessary during any stage of pregnancy. Indications for pregnancy-related surgery include cervical incompetence, the presence of ovarian cysts, and conditions amenable to fetal surgery. Indications for nonpregnancy-related surgery include the presence of acute abdominal disease (most commonly appendicitis and cholecystitis), malignancies, and trauma. When caring for pregnant women undergoing nonobstetric surgery, anesthesia providers may need to modify standard anesthetic protocols to accommodate pregnancy-induced maternal physiologic changes and the presence of the fetus. Possible fetal risks of antenatal surgery include (1) the effects of the disease process itself, or related therapy; (2) the teratogenicity of anesthetic agents or other drugs administered during the perioperative period; (3) intraoperative perturbations of uteroplacental perfusion and/or fetal oxygenation; and (4) preterm delivery or fetal demise.
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