Inadvertent Perforation of a Gravid Uterus During Laparoscopy

Post, Rebecca J.; Friedrich, E. P.; Amaya, Kevin; Chmait, Ramen H.

doi:10.4293/jsls.2019.00026

Cited by 8 publications

(3 citation statements)

References 6 publications

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“…Also, the majority of pregnant women with a diagnosis of appendicitis belonged to the lowest-income stratum. Additionally, the increased adjusted odds of death observed for pregnant women with acute appendicitis as compared to those without the disease indicates the potential for lethal complications among women facing both pregnancy and appendicitis, including perforated appendix, laceration of uterus during surgical intervention and post-surgical infections [ 16 , 17 ].…”

Section: Resultsmentioning

confidence: 99%

Trends in Appendicitis Among Pregnant Women, the Risk for Cardiac Arrest, and Maternal–Fetal Mortality

et al. 2020

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Background Appendicitis is the most common extra-uterine surgical emergency requiring immediate intervention during pregnancy. However, risks for mortality and morbidity among pregnant women with appendicitis remain poorly understood. This study was conducted to determine the temporal trends of appendicitis in pregnant women, and to calculate the risk of maternal–fetal mortality and near-miss marker (i.e., cardiac arrest) among pregnant women in general, and by race/ethnicity. Methods We conducted this retrospective study using data from the Nationwide Inpatient Sample (NIS) from January 1, 2002, through December 31, 2015. Joinpoint regression was used to estimate and describe temporal changes in the rates of all and acute appendicitis during the 14-year study period. We also estimated the risk of cardiac arrest, maternal, and fetal mortality among mothers of various racial/ethnic groups with a diagnosis of acute appendicitis. Within each group, patients without acute appendicitis were the referent category. Results and conclusions Out of the 58 million pregnancy hospitalizations during the study period, 63,145 cases (10.74 per 10,000 hospitalizations) were for acute appendicitis. There was a 5% decline (95% CI: − 5.1, − 5.0) in the rate of appendicitis hospitalizations over the period of the study. After adjusting for covariates, pregnant mothers with acute appendicitis had increased likelihood when compared to those without acute appendicitis to suffer fetal loss (OR: 2.05, 95% CI: 1.85–2.28) and nearly fivefold increase for inpatient maternal death. In conclusion, appendicitis during pregnancy remains an important cause of in-hospital maternal–fetal mortality overall and regardless of race/ethnicity.

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Section: Resultsmentioning

confidence: 99%

Trends in Appendicitis Among Pregnant Women, the Risk for Cardiac Arrest, and Maternal–Fetal Mortality

et al. 2020

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“…The abdominal cavity access technique in pregnant patients is controversial. Complications have been described with any entry technique [ [28] , [29] , [30] , [31] ]. In our series, open access with Hasson was routinely used and no uterine, vascular or visceral lesions occurred.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic treatment for appendicitis during pregnancy: Retrospective cohort study

Chwat

Terres

Duarte

et al. 2021

Annals of Medicine &Amp; Surgery

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Background Acute appendicitis is the most frequent non-obstetric surgical emergency during pregnancy. The benefits of laparoscopy during pregnancy are well known, but complications can occur, and these can affect both the mother and/or the foetus. We present results of laparoscopic surgical treatment of acute appendicitis in pregnant women, analysing the occurrence of adverse postoperative, obstetric and foetal outcomes and reviewing literature. Materials and methods Retrospective observational study on pregnant women with a preoperative diagnosis of acute appendicitis. Results n = 63, mean age 28.4 years, average gestational age of 17.7 weeks (3–30 weeks). 6.4 % exploratory laparoscopies, 92 % laparoscopic appendectomies and one right colectomy were performed. Conversion rate was 3.2 %. When symptoms begun within 48 hours prior to surgery, a perforated appendicitis was found in 11 %; whereas when the time from symptom onset to surgery was greater than or equal to 48 hours, it was evident in 31 % of the cases (p 0.008). The only independent variable associated with the presence of postoperative complications was symptom duration prior to surgery greater than or equal to 48 hours (OR 4.8; 95 % CI 1.1–16.2; p 0.04). Seven minor and 2 mayor postoperative complications were observed. Patients with complications spent, on average, twice as many days hospitalized (p < 0.001); and had 8 times more risk of preterm delivery (p 0.03). Obstetric complications were more frequent in pregnant women operated during the first trimester. Foetal mortality was 1.6 %. Conclusion Surgical morbidity of acute appendicitis in pregnant women is linked to the delay in the diagnosis and treatment of the inflammatory condition. Laparoscopic appendectomy during pregnancy is not exempt from postoperative, obstetric and foetal complications. It is necessary to standardize the definitions of “complication” in order to collate reliably the outcomes presented in the literature.

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“…In fact, cholecystectomy is the second most common nonobstetrical surgical procedure performed during pregnancy, occurring in 1 in 1600 to 10,000 pregnancies. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 Pregnancy is a known risk factor for gallstone formation given the increased levels of circulating estrogen and progesterone, leading to cholestasis and supersaturation of bile with cholesterol. 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

Pregnant patients undergoing cholecystectomy: nationwide assessment of clinical characteristics and outcomes

Mazza,

Youssefzadeh,

Aberle

et al. 2024

AJOG Global Reports

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Inadvertent Perforation of a Gravid Uterus During Laparoscopy

Cited by 8 publications

References 6 publications

Trends in Appendicitis Among Pregnant Women, the Risk for Cardiac Arrest, and Maternal–Fetal Mortality

Trends in Appendicitis Among Pregnant Women, the Risk for Cardiac Arrest, and Maternal–Fetal Mortality

Laparoscopic treatment for appendicitis during pregnancy: Retrospective cohort study

Pregnant patients undergoing cholecystectomy: nationwide assessment of clinical characteristics and outcomes

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