Dizon Arthur M, Carey Erin T
Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Curr Opin Obstet Gynecol. 2018 Aug;30(4):267-271. doi: 10.1097/GCO.0000000000000469.
Nonobstetric surgery is performed in 1 : 200 to 1 : 500 of pregnant women in the United States annually. Previously, many argued that laparoscopy was contraindicated during pregnancy because of concerns for uterine injury and fetal malperfusion. Because surgeons have gained more experience with laparoscopy, it has become the preferred treatment modality for many surgical diseases in the gravid patient.
Specific preoperative considerations, intraoperative techniques, and postoperative management per trimester will be reviewed to optimize patient and surgical outcomes.
The advantages of laparoscopic surgery are similar for pregnant and nonpregnant women. Surgery during pregnancy should minimize risks to both the fetus and the mother. Whenever a pregnant woman undergoes nonobstetric surgery, consultations among her surgical team are important to coordinate management. Both anatomic and physiologic changes related to pregnancy may require modifications in management. Surgeons must be aware of considerations, techniques, and postoperative management used for pregnant patients to optimize outcomes for both the fetus and mother.
在美国，每年有1/200至1/500的孕妇接受非产科手术。以前，许多人认为由于担心子宫损伤和胎儿灌注不良，妊娠期间腹腔镜检查是禁忌的。随着外科医生在腹腔镜检查方面积累了更多经验，它已成为许多妊娠期外科疾病的首选治疗方式。
将对每个孕期的具体术前注意事项、术中技术和术后管理进行综述，以优化患者和手术结局。
腹腔镜手术对孕妇和非孕妇的益处相似。孕期手术应尽量减少对胎儿和母亲的风险。每当孕妇接受非产科手术时，其手术团队之间的会诊对于协调管理很重要。与妊娠相关的解剖和生理变化可能需要在管理上进行调整。外科医生必须了解用于孕妇的注意事项、技术和术后管理，以优化胎儿和母亲的结局。
