Your doctor recommends surgery. The only problem is you’re also pregnant! While surgery during pregnancy isn’t ideal, around 75,000 women who are pregnant have surgery every year. So, if you must have a surgical procedure while you’re carrying a child, you’re not alone. Of course, you’d probably like to know more about the potential risks of undergoing a surgical procedure when you’re pregnant. Let’s look at the issue more closely.
Unfortunately, having surgery during pregnancy carries additional risk. That’s why doctors typically recommend postponing non-urgent surgery until at least six weeks after delivery. However, in certain situations, surgery may be necessary even while you’re pregnant. For example, if you have an inflamed appendix, that’s not a surgery that can wait. In other cases, you might need a procedure relatively quickly but it’s not a true emergency. If so, your doctor may recommend delaying surgery until your second trimester. During the second trimester is when you and your baby have the lowest risk of complications from surgery.
What type of complications could you or your baby experience during or after surgery? Although having a surgical procedure while you’re pregnant doesn’t place your baby at higher risk of birth defects, it does elevate the risk of a spontaneous abortion or delivery of a low birth weight baby. The risk doesn’t seem to rise just from the anesthesia but from the surgical procedure itself. Under certain circumstances, surgery can reduce blood flow to a developing fetus or otherwise compromise a baby’s normal development. Laparoscopic procedures appear to be safer than open surgery. It’s also safer if you get regional or local anesthesia rather than general anesthesia where you’re put to sleep.
How high is the risk of miscarriage as a result of surgery? According to Medscape.com, the risk is 5.8%, although it increases to 10.5% during the first trimester of pregnancy. As mentioned, the second trimester is the safest time to have a surgical procedure, if surgery is necessary. The risk of miscarriage falls to 1% for surgery during this trimester. During the third trimester, the uterus is larger and there’s more chance to irritate it and trigger pre-term labor. Surgeries that involve the abdomen or pelvis are most risky during this time.
Anesthetic agents, too, have the potential to be harmful to a developing baby and the risk is greatest during the first trimester since this is a period when your baby is rapidly growing and developing. Still, studies don’t show that surgery requiring anesthesia increases the risk of birth defects. That’s reassuring. Plus, if you do require surgery, you’ll have the benefit of a team of health care providers who have experience in this area, including an obstetrician, anesthesiologist, and a pediatrician. They will monitor you and your baby closely throughout the entire procedure to lower the risk of complications.
Just as with other forms of surgery, it’s best to avoid non-emergency dental surgery during the first trimester of pregnancy whenever possible. Of course, it’s always important to let your dentist and staff know if you’re pregnant at each visit.
Having surgery while you’re pregnant isn’t ideal and does carry some risk, although this risk can be successfully managed.
Contin Educ Anaesth Crit Care Pain (2006) 6 (2): 83-85.
Medscape.com. “Anaesthesia for Non-obstetric Procedures During Pregnancy”
Colgate Oral Care Center. “Anesthesia During Pregnancy”