Comparative study on the impact of laparoscopy and abdominal laparotomy to maternal-fetal at gestation period

Abstract

Objective To compare and analyze the impact on maternal-fetal of laparoscopy and abdominal laparotomy and evaluate the safety of laparoscopy during pregnancy.Methods In this prospective controlled study,20 pregnant patients underwent a laparoscopy,and the other 20 pregnant patients underwent an exploratory laparotomy during the same period of time.The parameters including anesthesia time,operative time,blood loss,arterial blood gas analysis in the fifteen minute after surgery,uterine artery blood flow,postoperative pain,postoperative recovery and pregnancy outcomes were collected.Results The anesthesia time and the operative time in laparoscopic group were significantly shorter than those in laparotomy group [(18.91 ± 8.76) min vs (35.28 ± 14.67) min,t=4.28,P ＜ 0.05,(17.85 ± 6.32) min vs (30.27 ± 10.41) min,t=4.56,P ＜ 0.05].The blood loss was significantly different during laparoscopic group and laparotomy group [(15.48 ± 10.24) ml vs (25.48 ± 15.56) ml,t=2.40,P ＜ 0.05].The stubbs catheter time,postoperative ambulation time,postoperative discharge time in the laparoscopic group were (6.58 ± 0.92) h,(6.98 ± 1.69) h and (18.52 ± 3.45) h respectively,while those were (24.63 ± 3.85) h,(25.37 ± 5.34) h,(23.67 ± 7.81) h in the laparotomy group (t=2.70,14.68,20.39; all P ＜ 0.05).The postoperative pain by laparoscopy was significantly lighter than that by laparotomy (P ＜ 0.05).There was no statistical significant difference between arterial blood gas analysis and uterine artery blood flow in two groups (P ＞ 0.05),and we didn't see any difference from abortion rate,premature birth rate,term delivery rate,the rate of birth defects,neonatal Apgar score and full-term birth weight.Conclusion Compared with laparotomy,laparoscopy has relatively less impact on maternal-fetal,and it won't increase the risk of adverse pregnancy outcomes. Key words: Laparoscopy; Laparotomy; Pregnancy; Safety; Uterine artery blood flow