Nonobstetric Surgery During Pregnancy: What Are the Risks of Anesthesia?

The need for anesthesia and surgery during pregnancy occurs in 1.5% to 2.0% of all pregnancies. Each year, over 75,000 pregnant women in the United States undergo nonobstetric surgery. The operations include those directly related to pregnancy (e.g., cerclage), those indirectly related to pregnancy (e.g., ovarian cystectomy), and those unrelated to gestation (e.g., appendectomy, cholecystectomy). The diagnosis of any medical condition requiring surgical intervention in pregnancy often raises questions about the safety of both surgery and anesthesia in these patients. This controversy was primarily attributed to the lay press speculations that surgery and anesthesia in pregnancy could pose hazards to the mother and fetus. Despite these concerns, the safety of nonobstetric surgery and anesthesia in pregnancy has been well established, and many pregnant women are safely anesthetized everyday without ill effects for the mother or fetus. Target Audience: Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this article, the reader should be able to list the mechanisms of teratogenicity, to describe the intraoperative monitoring of a pregnant patient undergoing surgery, and to outline the particular issues associated with providing anesthesia to a pregnant patient undergoing cardiac and neurosurgical procedures.