Appendectomy during pregnancy: a Swedish registry study of 778 cases

Article Abstract:

The medical records of 778 pregnant women who had had appendectomies (surgery to remove the appendix) performed in Sweden between 1973 and 1981 were reviewed to determine the effect of this surgical procedure on the fetus. Two hundred seventy-two of the operations were performed between weeks 3 and 13 of pregnancy, 400 between weeks 14 and 27, and 106 after week 28. A correct diagnosis of appendicitis (inflammation of the appendix) was made more often during the first trimester of pregnancy than later in the pregnancy. One hundred seventy-eight of the women had appendectomies between weeks 24 and 36 of pregnancy. Of these women, 22 percent delivered within one week following their operation. Twenty-eight delivered on the day of the operation, five delivered the day after, two delivered on the second day, one delivered on the third day, and three delivered on the sixth day after surgery. There were a total of 14 fetal deaths, four stillborn and 10 live births resulting in death within seven days. Serious developmental abnormalities, lung problems and bleeding in the brain (cerebral hemorrhage) were the main causes of death. The average birth weight was approximately 78 grams (0.2 lbs) less than expected, and the number of low-birth-weight babies (those weighing less than 6.5 pounds) was greater than expected. The results of this study suggest that appendectomy performed after week 23 of pregnancy is associated with an increased risk of early delivery (occurring within one week of surgery), an increase in the number of infant deaths occurring within seven days of birth, a decrease in the average birth weight, and an increase in the number of infants with low birth weight. The surgery was not associated with an increase in the number of stillborn infants or the number of infants with birth defects. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Cases, Sweden, Fetus, Pregnancy, Complications of, Pregnancy complications

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Reproductive outcome after anesthesia and operation during pregnancy: a Registry study of 5405 cases

Article Abstract:

The outcome of infants born to mothers who have nonobstetrical surgery during pregnancy is not known. This study reviewed the incidence of adverse fetal outcomes, particularly congenital malformation, stillbirth, death within 168 hours after birth (one week), and low and very low birth weight when maternal surgery was performed in either the first or second trimester of pregnancy (within the first six months). Operations were performed on 5,405 out of 720,000 pregnant women. There was no increase in the number of congenital malformations or stillbirths in the infants born to mothers who had surgery during pregnancy. However, there was an increase in the number of low birth weight and very low birth weight infants. These low weights were associated with premature delivery or intrauterine growth retardation. There was also an increase in the number of infants who died within 168 hours after birth. No particular anesthesia or surgery was related to the adverse outcomes; no other causes were determined.

Causes of, Complications and side effects, Risk factors, Birth weight, Low, Low birth weight, Anesthesia, Fetal death

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Reattempting failed external cephalic version under epidural anesthesia

Article Abstract:

Reorienting a fetus in breech position under epidural anesthesia may increase the likelihood of successful vaginal delivery following a failed external cephalic version. When a fetus is entering the birth canal feet-first, doctors may attempt to reposition the fetus by external manipulation. Researchers evaluated external version in 108 women carrying a single fetus. External version was successful in 60% of cases. Sixteen women had cephalic version reattempted under anesthesia, and seven successfully delivered their child vaginally. Overall, 71% of attempted cephalic versions successfully reoriented the child.

Health aspects, Care and treatment, Methods, Peridural anesthesia, Epidural anesthesia, Breech delivery, Breech birth, Version (Obstetrics)

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