Surgery dur­ing preg­nancy car­ries low risk of com­pli­ca­tions

Kuwait Times - - HEALTH & SCIENCE -

Sur­gi­cal pro­ce­dures dur­ing preg­nancy are gen­er­ally safe, new re­search in­di­cates. “Clearly, surgery dur­ing preg­nancy should only be con­sid­ered if ab­so­lutely nec­es­sary,” said Paul Aylin, study co-au­thor and an epi­demi­ol­o­gist at the Im­pe­rial Col­lege Lon­don in Eng­land.

But when ex­pec­tant mothers do need to un­dergo surgery, “the in­for­ma­tion pro­vided in our anal­y­sis may give re­as­sur­ance,” he told Reuters Health by email. Aylin and col­leagues used Eng­land’s na­tional hospi­tal data­base to iden­tify nearly 6.5 mil­lion preg­nan­cies be­tween 2002 and 2012, in­clud­ing 47,628 in which the moms had nonob­stet­ric surgery.

The most com­mon op­er­a­tions in­volved the ab­domen, den­tal is­sues, the nails and skin, or­tho­pe­dic con­di­tions, the ear, nose or throat, the pe­ri­anal re­gion, and the breast. Over­all, surgery dur­ing preg­nancy was as­so­ci­ated with a higher risk of birth com­pli­ca­tions, but the amount of that in­creased risk that could be blamed on the surgery was rel­a­tively small, ac­cord­ing to the au­thors.

They found that for ev­ery 143 surg­eries, there was one ex­tra case of a hospi­tal mis­car­riage. In ad­di­tion, there was one ex­tra still­birth among ev­ery 287 women who had surgery, one preterm de­liv­ery among ev­ery 31 surgery pa­tients, one un­der­weight baby for ev­ery 39 women in the surgery group, and one ma­ter­nal death for ev­ery 7,962 surg­eries.

Four times higher risk

Ap­prox­i­mately two-thirds of all ab­dom­i­nal op­er­a­tions were la­paro­scopic - but la­paro­scopic ab­dom­i­nal surgery was linked with a nearly four times higher risk of mis­car­riage com­pared with open ab­dom­i­nal surgery, the au­thors found.

Fewer than 6 per­cent of the op­er­a­tions oc­curred within one week of the end of preg­nancy, how­ever. Over­all, after ac­count­ing for other fac­tors that might in­crease ex­pec­tant mothers’ risks for th­ese bad out­comes, nonob­stet­ric surgery was found to in­crease the risk by 0.7 per­cent for mis­car­riage, 0.4 per­cent for still birth, 3.2 per­cent for preterm de­liv­ery, 2.6 per­cent for low birth weight, 4 per­cent for ce­sarean sec­tion, and 0.013 per­cent for ma­ter­nal death, the au­thors re­ported in An­nals of Surgery.

“This study puts it into perspective that other risk fac­tors are at play and this is the amount of risk that can be blamed on the surgery,” said Dr. Daniela Carusi, an ob­ste­tri­cian gy­ne­col­o­gist and di­rec­tor of Sur­gi­cal Ob­stet­rics at Brigham and Women’s Hospi­tal in Boston.

“The risk you can at­tribute to surgery may be small, but it’s not zero,” said Carusi, who was not in­volved with the study. “Be­cause of that, it’s im­por­tant to con­sider the safest al­ter­na­tive.” In some cases, it might be bet­ter to wait. “But if it’s a med­i­cal con­di­tion, like ap­pen­dici­tis, then surgery may be the bet­ter op­tion,” she said. — Reuters

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