Garg Adit Mohan, Mysore Venkataram
Department of Dermatology, Venereology and Leprosy, Alok Hospital, Centre for Advanced Skin, Cosmetic and Plastic Surgery, Kota, Rajasthan, India.
Department of Dermatology, Venereology and Leprosy, The Venkat Center for Skin and Plastic Surgery, Post Graduate Training Center (RGUHS), Bengaluru, Karnataka, India.
J Cutan Aesthet Surg. 2022 Apr-Jun;15(2):108-117. doi: 10.4103/JCAS.JCAS_226_20.
Patients may develop a need to undergo procedures while being pregnant and this requires a certain risk-benefit profiling to be done by the clinician. Skin changes during pregnancy such as melasma, striae, varicose veins, hirsutism, and increased skin growths may raise concerns for the lady. Although pregnancy-induced physiologic changes may prompt a surgeon to delay nonessential procedures until after delivery, certain skin conditions may require urgent intervention. Others that may be nonurgent, elective, or cosmetic may need careful analysis.
Data were extracted from available literature through a PubMed search for the following keywords: "dermatological procedures in pregnancy," "dermatosurgical procedures during pregnancy," "aesthetic procedures in pregnancy," "safety in pregnancy," "teratogenicity of drugs," "local anesthesia during pregnancy," "physiological changes in pregnancy," "cosmetic procedures during pregnancy," and "lasers in pregnancy."
Only procedures which are safe and necessary should be carried out in a pregnant woman. Electrocautery, radiofrequency, cryotherapy, and lasers for warts, particularly genital, surgical interventions for skin malignancies, and other small growths should be performed. Safe but cautious outlook is required for intralesional steroid injections, aesthetic procedures such as chemical peeling, botulinum toxin, microdermabrasion, and biopsies for questionable lesions. Absolutely contraindicated procedures include fillers, sclerotherapy, and liposuction.
患者在怀孕期间可能需要接受手术，这就要求临床医生进行特定的风险效益分析。怀孕期间的皮肤变化，如黄褐斑、妊娠纹、静脉曲张、多毛症以及皮肤赘生物增多，可能会让女性产生担忧。尽管妊娠引起的生理变化可能促使外科医生将非必要手术推迟到分娩后进行，但某些皮肤状况可能需要紧急干预。其他可能并非紧急、属于选择性或美容性的情况则需要仔细分析。
通过在PubMed上搜索以下关键词，从现有文献中提取数据：“妊娠期皮肤科手术”“妊娠期皮肤外科手术”“妊娠期美容手术”“妊娠期安全性”“药物致畸性”“妊娠期局部麻醉”“妊娠期生理变化”“妊娠期美容手术”以及“妊娠期激光治疗”。
仅应为孕妇实施安全且必要的手术。对于疣，特别是生殖器疣，应进行电灼、射频、冷冻疗法及激光治疗；对于皮肤恶性肿瘤及其他小的赘生物，应进行手术干预。对于皮损内注射类固醇、化学剥脱、肉毒毒素、微晶磨皮等美容手术以及对可疑病变进行活检，需要采取安全但谨慎的态度。绝对禁忌的手术包括填充剂注射、硬化疗法和抽脂术。
