Preoperative considerations and most common non-obstetric surgical conditions in pregnancy

Introduction. During pregnancy, approximately 1-2% of patients undergo non-obstetric surgical interventions. Pregnant women are considered at increased risk in the perioperative period, due to anatomical and physiological changes that occur during gravidity. Anatomical and physiological changes. Changes in the respiratory tract are especially pronounced towards the end of pregnancy. These changes include swelling of the oropharyngeal tissues and reduced caliber of the glottis, which can lead to difficulty during ventilation and intubation. Perioperative anesthesiological considerations. Carefully titrating anesthetics is essential, as drug requirements are usually reduced during pregnancy. Medications and toxicity. Drugs administered during pregnancy may have a harmful effect on the fetus depending on dosage, method of administration and time of exposure. Despite years of animal experiments and observational studies in humans, no anesthetic has been shown to be clearly dangerous to the human fetus. Fetal monitoring. Accurate interpretation of fetal heart rate patterns and understanding of the effects of anesthetics enable effective monitoring of fetal well-being and informed decision-making regarding intraoperative care for the safety of both mother and fetus. Non-obstetric surgical conditions. Appendicitis and cholecystitis are the two most common surgical conditions that require treatment during pregnancy. Other more common conditions are chronic inflammatory bowel diseases and pancreatitis. Traumatic injuries of pregnant patients are a special topic. Conclusion. Comprehensive preoperative preparation should performed before every surgical intervention. Pregnant women should never be denied an emergency indicated surgical procedure, regardless of the current trimester of pregnancy.