Emergency laparoscopic surgery in pregnancy

Ammari Smail *

Department of General Surgery, Ain Taya Hospital, Algiers, Faculty of Medicine of Algiers, Algiers University 1, Algeria.
 
Research Article
World Journal of Advanced Research and Reviews, 2024, 22(02), 1456–1460
Article DOI: 10.30574/wjarr.2024.22.2.1564
 
Publication history: 
Received on 11 April 2024; revised on 17 May 2024; accepted on 20 May 2024
 
Abstract: 
Introduction: The decision to proceed with surgical intervention is often difficult in pregnant women, particularly in emergency contexts. Opting for laparoscopic surgery in pregnant women is even more challenging. Concerns during laparoscopic procedures include potential fetal injury, reduced uterine blood flow due to pneumoperitoneum, and fetal acidosis. The objective of our study is to evaluate the feasibility and morbidity-mortality of emergency laparoscopy in pregnant women.
Materials and Methods: This is a descriptive and prospective study conducted between February 2018 and October 2021, involving 337 patients who underwent laparoscopic surgery for acute non-traumatic abdominal emergencies.
Results: Among the 190 female patients operated on, 18 patients (9.47%) were pregnant: 8 (44.5%) had acute appendicitis, 7 (38.9%) had acute lithiasic cholecystitis, 2 (11.2%) had ovarian cyst torsion, and 1 (5.6%) had an appendiceal abscess. This laparoscopic management was performed across different gestational ages. The mean gestational age of our patients was 15 ± 14 weeks of amenorrhea (minimum 7 weeks, maximum 29 weeks). The mean operative time for the surgical interventions in these pregnant women was 61.2 minutes ± 20.16 minutes. No intraoperative complications or incidents, no conversions, and no abortions were recorded.
Conclusion: Laparoscopy can be safely used to manage acute non-traumatic abdominal emergencies during pregnancy.
 
Keywords: 
Acute abdomen; Pregnancy; Laparoscopy; Fetal injury
 
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