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Minimally invasive gynecologic surgery in the pregnant patient: considerations, techniques, and postoperative management per trimester

Dizon, Arthur M.; Carey, Erin T.

Current Opinion in Obstetrics and Gynecology: August 2018 - Volume 30 - Issue 4 - p 267–271
doi: 10.1097/GCO.0000000000000469
MINIMALLY INVASIVE GYNECOLOGIC PROCEDURES: Edited by Matthew T. Siedhoff

Purpose of review 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.

Recent findings Specific preoperative considerations, intraoperative techniques, and postoperative management per trimester will be reviewed to optimize patient and surgical outcomes.

Summary 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.

Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

Correspondence to Arthur M. Dizon, MD, MSCR, Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 4010 Old Clinic Building CB 7570, Chapel Hill, NC 27599, USA. Tel: +1 984 215 3050; fax: +919 595 5648; e-mail: mitchdizon@gmail.com

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