Operating Room Setup and Patient Positioning for Non-obstetric Surgery During Pregnancy

Abstract

Elective surgery is generally avoided during pregnancy if observation and medical management are possible. However, carefully planned non-obstetric surgeries may be performed if required while still ensuring the safety of both the mother and the fetus. The incidence of women requiring non-obstetric surgery during their pregnancy is similar to the frequency of nonpregnant women of childbearing age requiring surgery. Representing about 2% of the female population in the United States, these patients require a variety of procedures and numerous surgical specialties. Therefore, the perioperative surgical team requires a comprehensive knowledge of safe patient positioning for non-obstetric surgical procedures. These concepts are described in detail in this chapter based on their application in conventional operating rooms although they may be successfully adapted to various procedural settings.

Laparotomy or laparoscopy may be necessary for appendicitis, acute cholelithiasis, ovarian masses, trauma, or intestinal obstruction. Appendicitis is the most common non-obstetric surgical condition that complicates pregnancy and occurs in approximately 2 in every 1000 pregnancies. This chapter provides guidance for safe and effective operating room configuration, setup, and positioning in the most common non-obstetric surgical procedures performed for pregnant surgical patients.