Non‐obstetric surgery during gestation: Risk factors for lower birthweight

Jenkins, Thomas M.; Mackey, Suzanne F.; Benzoni, Elisa M.; Tolosa, Jorge E.; Sciscione, Anthony

doi:10.1046/j.0004-8666.2003.00001.x

Cited by 53 publications

(58 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There were no significant differences in the birthweight between the two groups. Moreover, Jenkins et al 43 reported that general anaesthesia, longer surgery duration and intra-abdominal procedures are associated with lower birthweight.…”

Section: Stillbirth and Low Birthweightmentioning

confidence: 99%

Estimating the risk of adverse birth outcomes in pregnant women undergoing non-obstetric surgery using routinely collected NHS data: an observational study

Aylin

Bennett

Bottle

et al. 2016

Health Serv Deliv Res

View full text Add to dashboard Cite

Background: Previous research suggests that non-obstetric surgery is carried out in 1 – 2% of all pregnancies. However, there is limited evidence quantifying the associated risks. Furthermore, of the evidence available, none relates directly to outcomes in the UK, and there are no current NHS guidelines regarding non-obstetric surgery in pregnant women. Objectives: To estimate the risk of adverse birth outcomes of pregnancies in which non-obstetric surgery was or was not carried out. To further analyse common procedure groups. Data Source: Hospital Episode Statistics (HES) maternity data collected between 2002 – 3 and 2011 – 12. Main outcomes: Spontaneous abortion, preterm delivery, maternal death, caesarean delivery, long inpatient stay, stillbirth and low birthweight. Methods: We utilised HES, an administrative database that includes records of all patient admissions and day cases in all English NHS hospitals. We analysed HES maternity data collected between 2002 – 3 and 2011 – 12, and identified pregnancies in which non-obstetric surgery was carried out. We used logistic regression models to determine the adjusted relative risk and attributable risk of non-obstetric surgical procedures for adverse birth outcomes and the number needed to harm. Results: We identified 6,486,280 pregnancies, in 47,628 of which non-obstetric surgery was carried out. In comparison with pregnancies in which surgery was not carried out, we found that non-obstetric surgery was associated with a higher risk of adverse birth outcomes, although the attributable risk was generally low. We estimated that for every 287 pregnancies in which a surgical operation was carried out there was one additional stillbirth; for every 31 operations there was one additional preterm delivery; for every 25 operations there was one additional caesarean section; for every 50 operations there was one additional long inpatient stay; and for every 39 operations there was one additional low-birthweight baby. Limitations: We have no means of disentangling the effect of the surgery from the effect of the underlying condition itself. Many spontaneous abortions will not be associated with a hospital admission and, therefore, will not be included in our analysis. A spontaneous abortion may be more likely to be reported if it occurs during the same hospital admission as the procedure, and this could account for the associated increased risk with surgery during pregnancy. There are missing values of key data items to determine parity, gestational age, birthweight and stillbirth. Conclusions: This is the first study to report the risk of adverse birth outcomes following non-obstetric surgery during pregnancy across NHS hospitals in England. We have no means of disentangling the effect of the surgery from the effect of the underlying condition itself. Our observational study can never attribute a causal relationship between surgery and adverse birth outcomes, and we were unable to determine the risk of not undergoing surgery where surgery was clinically indicated. We have...

show abstract

Section: Stillbirth and Low Birthweightmentioning

confidence: 99%

Estimating the risk of adverse birth outcomes in pregnant women undergoing non-obstetric surgery using routinely collected NHS data: an observational study

Aylin

Bennett

Bottle

et al. 2016

Health Serv Deliv Res

View full text Add to dashboard Cite

show abstract

“…Jenkins et al found that surgery in the second trimester results in the lowest rate of preterm birth compared to the first trimester. 5 In another study, the rate of major birth defects among women who underwent non-obstetric surgery in the first trimester was reported as 3.9%. 4 A decrease in maternal blood flow may cause reduced placental perfusion and fetal hypoxia.…”

Section: Discussionmentioning

confidence: 99%

“…malities, spontaneous abortion and lower birth weight. 4,5 We reported the case of a patient with 8 weeks of pregnancy who underwent successful fracture surgery under combined spinal-epidural anaesthesia.…”

Section: Anesthetic Management For Lower Extremity Fractures Surgery mentioning

confidence: 99%

Anesthetic Management for Lower Extremity Fractures Surgery in a Patient with Eight Weeks of Gestation: Case Report

Aksoy¹,

Aksoy²,

Dostbil³

et al. 2015

Turkiye Klinikleri J Case Rep

View full text Add to dashboard Cite

A pproximately 0.5-2% of all pregnant women undergo non-obstetric surgery during gestation.1 Operations during pregnancy may be related to pregnancy such as cerclage or unrelated to pregnancy such as cholecystectomy or trauma. The type of anesthetic technique is important in all trimesters of pregnancy due to the maternal and neonatal side effects. Especially, the organogenesis period (from 18 to 58 days after conception) has maximum sensitivity to teratogens and anesthetic agents. A AB BS ST TR RA AC CT T Both anesthetic techniques and surgery in the first trimester can adversely affect fetal development during pregnancy and may cause premature birth, fetal abnormalities, spontaneous abortion and lower birth weight. Especially, the organogenesis period (from 18 to 58 days after conception) has maximum sensitivity to teratogens and anesthetic agents. A 26-year-old, previously healthy female was admitted to the Emergency Department with shaft fracture of the left tibia and fibula. Eight weeks of gestation was defined via obstetrics ultrasound. Using combined spinal-epidural anesthesia with 2% lidocaine in a graded fashion provided safe anaesthesia for both the mother and the developing fetus. This case presents the anesthetic approach in a patient with first trimester pregnancy that underwent a surgery due to left tibia and fibula fractures. If non-obstetric surgery is inevitable in the first trimester, the safest anesthesia for both the mother and the baby must be preferred.K Ke ey y W Wo or rd ds s: : Pregnancy; anesthesia; tibial fractures; surgery Ö ÖZ ZE ET T İlk trimesterde yapılan ameliyat ve kullanılan anestezi teknikleri, gebelik süresince fetüsün gelişimini olumsuz etkileyebilir ve erken doğum, fetal anormallikler, spontan abortus ve düşük doğum ağırlığına sebep olabilir. Özellikle, organegenezis dönemi (konsepsiyondan sonraki 18'den 58. güne kadar olan dönem) teratojenlere ve anestezik ajanlara en fazla duyarlılığa sahiptir. Daha önceden sağlıklı olan 26 yaşındaki kadın hasta sol tibia ve fibula kırığı ile Acil Servis'e müracaat etti. Obstetrik ultrason ile 8 haftalık gebelik tespit edildi. Kombine spinal-epidural anestezi kullanılarak %2 lidokain solusyonunun kademeli şekilde uygulanması ile anne ve gelişmekte olan fetüs için gü-venli anestezi sağlandı. Bu vaka raporunda sol tibia ve fibula kırığı sebebi ile ameliyat geçiren ilk trimester gebeliği olan bir hastadaki anestezi yaklaşımı sunulmuştur. Eğer ilk trimesterde cerrahi müdahale kaçınılmaz ise anne ve bebek için en güvenli olan anestezi tercih edilmelidir.A An na ah ht ta ar r K Ke el li im me el le er r: : Gebelik; anestezi; tibia kırıkları; cerrahi T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J C Ca as se e R Re ep p 2 20 01 15 5; ;2 23 3( (4 4)

show abstract

“…In the late second trimester surgery should be delayed to at least 28 weeks, when the fetal survival of over 90% is achievable (Loughlin, KR., 1995). In the early second trimester however, immediate surgery is recommended by some of the authors due to the low risk of the fetal loss (FazeliMatin, S., et al, 1998;Gnessin, E., et al, 2002;Jenkins, TM., et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Nephron-Sparing Surgery and Caesarian Section for the Treatment of Renal Cell Carcinoma in Pregnancy: Case Report and Review of the Literature

Pertia¹,

Managadze²,

Chkhotua³

2012

Emerging Research and Treatments in Renal Cell Carcinoma

View full text Add to dashboard Cite

Non‐obstetric surgery during gestation: Risk factors for lower birthweight

Abstract: While non-obstetric surgery appears to be relatively safe during gestation, general anaesthesia, longer surgery time, and intra-abdominal procedures are associated with lower birthweights.

Cited by 53 publications

References 16 publications

Estimating the risk of adverse birth outcomes in pregnant women undergoing non-obstetric surgery using routinely collected NHS data: an observational study

Estimating the risk of adverse birth outcomes in pregnant women undergoing non-obstetric surgery using routinely collected NHS data: an observational study

Anesthetic Management for Lower Extremity Fractures Surgery in a Patient with Eight Weeks of Gestation: Case Report

Simultaneous Nephron-Sparing Surgery and Caesarian Section for the Treatment of Renal Cell Carcinoma in Pregnancy: Case Report and Review of the Literature

Contact Info

Product

Resources

About