Nonobstetrical Surgical Conditions

Abstract

Prompt diagnosis and appropriate interventions for nonobstetrical surgical emergencies are important in pregnancy because a delay in diagnosis can result in increased morbidity and mortality to both mother and fetus. Generally, neither anesthesia nor surgical procedures increase the risk of congenital malformations or miscarriage. The diagnosis of a surgical condition is often more difficult in pregnant women than in nonpregnant adults because the traditional signs and symptoms of a specific disorder may not be exhibited due to the anatomic and physiologic changes of pregnancy. Moreover, the surgeon may need to make accommodations and adjustments as a result of the anatomic and physiologic changes associated with pregnancy, which may include limitations imposed by uterine size, unusual clinical presentation, and adjustments to accommodate fetal monitoring and optimize fetal well-being. Therefore, a multidisciplinary team approach (involving obstetricians, general surgeons, anesthesiologists, and neonatologists) is required in nonobstetrical surgeries involving pregnant women. This review contains 3 figures, 3 tables, and 32 references. Key Words: adnexal torsion, anesthesia, appendicitis, cholecystitis, laparoscopy, pregnancy, radiation, surgery