Sugammadex administration in pregnant patients undergoing non-obstetric surgery: a case series

Torres, Sara Martins; Duarte, Duarte Filipe; Glória, Amélia Sousa; Reis, C.G; Moreira, Joana; Cunha, Sara Bernardes da; Gomes, Lúcia; Dahlem, Caroline

doi:10.1016/j.bjane.2021.07.034

Cited by 7 publications

(17 citation statements)

References 2 publications

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“…Fourteen studies reported population-based data, [10][11][12]15,22,23,26,29,31,33,35,42,45,50 three studies reported multicenter data 36,39,60 and 43 studies reported single-center data, 13,14,[16][17][18][19][20][21]24,25,27,28,30,32,34,37,38,40,41,43,44,[46][47][48][49][51][52][53][54][55][56][57][58][59][61]…”

Section: Resultsmentioning

confidence: 99%

“…Fourteen studies reported population-based data, 10–12,15,22,23,26,29,31,33,35,42,45,50 three studies reported multicenter data 36,39,60 and 43 studies reported single-center data, 13,14,16–21,24,25,27,28,30,32,34,37,38,40,41,43,44,46–49,51–59,61–69 and all, expect one small prospective single-center study on 22 women,63 were retrospective.…”

Section: Resultsmentioning

confidence: 99%

“…Data regarding the trimester when surgery was performed were available in the majority of the studies. 11–14,16,17,19,21–25,28–30,32,35–39,41,42,47–51,53,54,56,59–63,66,68,69 There were data for 47,153 pregnant women; 43% of procedures were carried out during the first, 32% during the second, and 25% during the third trimester.…”

Section: Comparison Of Trimestersmentioning

confidence: 99%

“…Preterm birth (birth before 37 weeks of pregnancy) was the most commonly reported outcome, reported in 54 studies. 10-17, 19-39, 41-46, 48, 50-54, 56-63, 65-69 There were 8265 (9.7%) preterm births in 67,367 pregnancies in women with non-obstetric surgery. Fourteen studies compared data on preterm births in women with non-obstetric surgery ( n = 73,110) and with no surgery during pregnancy ( n = 14,833,865).…”

Section: Description Of the Studies According To The Fetal And Matern...mentioning

confidence: 99%

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Non-obstetric surgery during pregnancy and the effects on maternal and fetal outcomes: A systematic review

et al. 2023

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Background and objective: Non-obstetric surgery is fairly common in pregnant women. We performed a systematic review to update data on non-obstetric surgery in pregnant women. The aim of this review was to evaluate the effects of non-obstetric surgery during pregnancy on pregnancy, fetal and maternal outcomes. Methods: A systematic literature search of MEDLINE and Scopus was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search span was from January 2000 to November 2022. Thirty-six studies matched the inclusion criteria, and 24 publications were identified through reference mining; 60 studies were included in this review. Outcome measures were miscarriage, stillbirth, preterm birth, low birth weight, low Apgar score, and infant and maternal morbidity and mortality rates. Results: We obtained data for 80,205 women who underwent non-obstetric surgery and data for 16,655,486 women who did not undergo surgery during pregnancy. Prevalence of non-obstetric surgery was between 0.23% and 0.74% (median 0.37%). Appendectomy was the most common procedure with median prevalence of 0.10%. Near half (43%) of the procedures were performed during the second trimester, 32% during the first trimester, and 25% during the third trimester. Half of surgeries were scheduled, and half were emergent. Laparoscopic and open techniques were used equally for abdominal cavity. Women who underwent non-obstetric surgery during pregnancy had increased rate of stillbirth (odds ratio (OR) 2.0) and preterm birth (OR 2.1) compared to women without surgery. Surgery during pregnancy did not increase rate of miscarriage (OR 1.1), low 5 min Apgar scores (OR 1.1), the fetus being small for gestational age (OR 1.1) or congenital anomalies (OR 1.0). Conclusions: The prevalence of non-obstetric surgery has decreased during last decades, but still two out of 1000 pregnant women have scheduled surgery during pregnancy. Surgery during pregnancy increases the risk of stillbirth, and preterm birth. For abdominal cavity surgery, both laparoscopic and open approaches are feasible.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Comparison Of Trimestersmentioning

confidence: 99%

Section: Description Of the Studies According To The Fetal And Matern...mentioning

confidence: 99%

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Non-obstetric surgery during pregnancy and the effects on maternal and fetal outcomes: A systematic review

et al. 2023

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“…O sugamadex -droga utilizada para reverter o bloqueio neuromuscular induzido por alguns agentes anestésicos -é comumente aplicado após partos cesarianos. Ao passo que não foram constatadas implicações materno-fetais na reversão da anestesia geral nas intervenções não obstétricas durante a gravidez com essa droga, no entanto, ainda não existe um consenso no meio científico, quanto a segurança desse fármaco nesse período (Torres et al, 2021).…”

Section: Implicações Anestesiológicas Durante a Gestaçãounclassified

Desafios da anestesiologia em procedimentos cirúrgicos não-obstétricos durante o período gestacional

Freitas

Sousa

Neto

2022

RSD

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As intervenções cirúrgicas não obstétricas em gestantes apesar de terem baixa incidência, acontecem, e necessitam de maiores estudos quanto ao manejo anestesiológico, devido a gestação ser um período marcado por alterações fisiológicas, hormonais e anatômicas para as mães, e de grande diferenciação celular e crescimento para os embriões e/ou fetos, o que a exposição destes a fármacos pode ser um fator de risco ao desenvolvimento. O objetivo deste estudo é analisar as implicações do manejo anestésico em cirurgias não obstétricas durante a gestação. Este trabalho é uma revisão sistemática da literatura, realizada através de artigos publicados na língua inglesa, entre 2017 e 2022, publicados nas bases de dados PUBMED e BVS, tendo por descritores: gravidez, anestesia, anormalidades congênitas. Constatou-se que: as anestesias neuroaxiais são mais indicadas no primeiro trimestre, devido a menor toxicidade; baixo peso fetal associado a anestesia geral; maioria das cirurgias são abdominais e ocorreram no segundo trimestre sob anestesia geral; maior prevalência de partos prematuros em gestantes que realizaram cirurgia no terceiro trimestre; necessidade de planejamento cirúrgico, manejo anestésico e monitorização fetal de acordo com as particularidades fisiológicas de cada gestante; e neurotoxicidade cerebral comprovada em testes animais. O planejamento anestesiológico é indispensável para minimizar os riscos da exposição fetal a toxicidade e a teratógenos, todavia é válido evidenciar que os anestésicos desde que aplicados nas dosagens padrão não apresentam riscos graves ao desenvolvimento do feto, porém além do cuidado multidisciplinar, é imprescindível que novos estudos sejam realizados para avaliar a neurotoxicidade cerebral desses fármacos nos fetos.

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Anaesthesia for non-obstetric surgery during pregnancy

Brakke

Sviggum

2023

BJA Education

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Sugammadex administration in pregnant patients undergoing non-obstetric surgery: a case series

Cited by 7 publications

References 2 publications

Non-obstetric surgery during pregnancy and the effects on maternal and fetal outcomes: A systematic review

Non-obstetric surgery during pregnancy and the effects on maternal and fetal outcomes: A systematic review

Desafios da anestesiologia em procedimentos cirúrgicos não-obstétricos durante o período gestacional

Anaesthesia for non-obstetric surgery during pregnancy

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