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Anesthesia for Nonobstetric Surgery During Pregnancy

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Obstetric Anesthesia Handbook

Abstract

It has been estimated that every year in the United States about 50,000 pregnant women (0.5–2.2%) will receive anesthesia for various surgical indications during their pregnancy. The purpose of this surgery may be (1) to prolong gestation, (2) unrelated to the pregnancy, or (3) to correct fetal anomalies. Hence, an understanding of the effects of different anesthetic drugs and techniques on the mother and fetus is essential to the safe administration of anesthesia to pregnant women undergoing surgery. Recently, a question of preoperative pregnancy testing in adolescents has been raised. The authors observed retrospectively 412 adolescent women undergoing surgery.

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References

  1. Azzam FJ, Padda GS, DeBoard JW, Krock JL, Kolterman SM. Preoperative pregnancy testing in adolescents. Anesth Analg. 1996;82(1):4–7.

    Article  PubMed  CAS  Google Scholar 

  2. Shnider SM, Webster GM. Maternal and fetal hazards of surgery during pregnancy. Am J Obstet Gynecol. 1965;92:891–900.

    PubMed  CAS  Google Scholar 

  3. Brodsky JB, Cohen EN, Brown BW, Jr., Wu ML, Whitcher C. Surgery during pregnancy and fetal outcome. Am J Obstet Gynecol. 1980;138(8):1165–1167.

    PubMed  CAS  Google Scholar 

  4. Smith BE. Fetal prognosis after anesthesia during gestation. Anesth Analg. 1963;42:521–526.

    Article  PubMed  CAS  Google Scholar 

  5. Kennedy RL, Miller RP, Bell JU, et al. Uptake and distribution of bupivacaine in fetal lambs. Anesthesiology. 1986;65(3):247–253.

    Article  PubMed  CAS  Google Scholar 

  6. Duncan PG, Pope WD, Cohen MM, Greer N. Fetal risk of anesthesia and surgery during pregnancy. Anesthesiology. 1986;64(6):790–794.

    Article  PubMed  CAS  Google Scholar 

  7. Mazze RI, Kallen B. Reproductive outcome after anesthesia and operation during pregnancy: a registry study of 5405 cases. Am J Obstet Gynecol. 1989;161(5):1178–1185.

    PubMed  CAS  Google Scholar 

  8. Vaisman AI. [Working conditions in the operating room and their effect on the health of anesthetists]. Eksp Khir Anesteziol. 1967;12(3):44–49.

    PubMed  CAS  Google Scholar 

  9. Knill-Jones RP, Rodrigues LV, Moir DD, Spence AA. Anaesthetic practice and pregnancy. Controlled survey of women anaesthetists in the United Kingdom. Lancet. 1972;1(7764):1326–1328.

    Article  PubMed  CAS  Google Scholar 

  10. Occupational disease among operating room personnel: a national study. Report of an Ad Hoc Committee on the Effect of Trace Anesthetics on the Health of Operating Room Personnel, American Society of Anesthesiologists. Anesthesiology. 1974;41(4):321–340.

    Google Scholar 

  11. Cohen EN, Gift HC, Brown BW, et al. Occupational disease in dentistry and chronic exposure to trace anesthetic gases. J Am Dent Assoc. 1980;101(1):21–31.

    PubMed  CAS  Google Scholar 

  12. Cohen EN, Brown BW, Jr. Occupational hazards of anaesthesia. Br Med J. 1980;281(6254):1568–1569.

    Article  PubMed  CAS  Google Scholar 

  13. Ericson HA, Kallen AJ. Hospitalization for miscarriage and delivery outcome among Swedish nurses working in operating rooms 1973–1978. Anesth Analg. 1985;64(10):981–988.

    Article  PubMed  CAS  Google Scholar 

  14. Rowland AS, Baird DD, Weinberg CR, Shore DL, Shy CM, Wilcox AJ. Reduced fertility among women employed as dental assistants exposed to high levels of nitrous oxide. N Engl J Med. 1992;327(14):993–997.

    Article  PubMed  CAS  Google Scholar 

  15. Heinonen OP, Slone D, Shapiro D, eds. Birth Defects and Drugs in Pregnancy. Littleton, MA: Publishing Sciences Group; 1977.

    Google Scholar 

  16. Slone D, Siskind V, Heinonen OP, Monson RR, Kaufman DW, Shapiro S. Antenatal exposure to the phenothiazines in relation to congenital malformations, perinatal mortality rate, birth weight, and intelligence quotient score. Am J Obstet Gynecol. 1977;128(5):486–488.

    PubMed  CAS  Google Scholar 

  17. Safra MJ, Oakley GP, Jr. Association between cleft lip with or without cleft palate and prenatal exposure to diazepam. Lancet. 1975;2(7933):478–480.

    Article  PubMed  CAS  Google Scholar 

  18. Milkovich L, van den Berg BJ. Effects of prenatal meprobamate and chlordiazepoxide hydrochloride on human embryonic and fetal development. N Engl J Med. 1974;291(24):1268–1271.

    Article  PubMed  CAS  Google Scholar 

  19. Koren G, Pastuszak A, Ito S. Drugs in pregnancy. N Engl J Med. 1998;338(16):1128–1137.

    Article  PubMed  CAS  Google Scholar 

  20. Gidai J, Acs N, Banhidy F, Czeizel AE. No association found between use of very large doses of diazepam by 112 pregnant women for a suicide attempt and congenital abnormalities in their offspring. Toxicol Ind Health. 2008;24(1–2):29–39.

    Article  PubMed  CAS  Google Scholar 

  21. Petik D, Acs N, Banhidy F, Czeizel AE. A study of the potential teratogenic effect of large doses of promethazine used for a suicide attempt by 32 pregnant women. Toxicol Ind Health. 2008;24(1–2):87–96.

    Article  PubMed  CAS  Google Scholar 

  22. Timmermann G, Acs N, Banhidy F, Czeizel AE. A study of teratogenic and fetotoxic effects of large doses of meprobamate used for a suicide attempt by 42 pregnant women. Toxicol Ind Health. 2008;24(1–2):97–107.

    Article  PubMed  CAS  Google Scholar 

  23. Geber WF, Schramm LC. Congenital malformations of the central nervous system produced by narcotic analgesics in the hamster. Am J Obstet Gynecol. 1975;123(7):705–713.

    PubMed  CAS  Google Scholar 

  24. Zagon IS, McLaughlin PJ. Effects of chronic morphine administration on pregnant rats and their offspring. Pharmacology. 1977;15(4):302–310.

    Article  PubMed  CAS  Google Scholar 

  25. Fujinaga M, Stevenson JB, Mazze RI. Reproductive and teratogenic effects of fentanyl in Sprague-Dawley rats. Teratology. 1986;34(1):51–57.

    Article  PubMed  CAS  Google Scholar 

  26. Fujinaga M, Mazze RI, Jackson EC, Baden JM. Reproductive and teratogenic effects of sufentanil and alfentanil in Sprague-Dawley rats. Anesth Analg. 1988;67(2):166–169.

    Article  PubMed  CAS  Google Scholar 

  27. Nicholls EA, Louie GL, Prokocimer PG, Maze M. Halothane anesthetic requirements are not affected by aminophylline treatment in rats and dogs. Anesthesiology. 1986;65(6):637–641.

    Article  PubMed  CAS  Google Scholar 

  28. Fujinaga M. Assessment of teratogenic effects of lidocaine in rat embryos cultured in vitro. Anesthesiology. 1998; 89(6):1553–1558.

    Article  PubMed  CAS  Google Scholar 

  29. Kitson K, Ormond K, Pergament E. Surgery in Pregnancy; 2000.

    Google Scholar 

  30. Bingol N, Fuchs M, Diaz V, Stone RK, Gromisch DS. Teratogenicity of cocaine in humans. J Pediatr. 1987;110(1):93–96.

    Article  PubMed  CAS  Google Scholar 

  31. Haring OM. Effects of prenatal hypoxia on the cardiovascular system in the rat. Arch Pathol. 1965;80(4):351–356.

    PubMed  CAS  Google Scholar 

  32. Haring OM. Cardiac malformations in rats induced by exposure of the mother to carbon dioxide during pregnancy. Circ Res. 1960;8:1218–1227.

    PubMed  CAS  Google Scholar 

  33. Fujikura T. Retrolental fibroplasia and prematurity in newborn rabbits induced by maternal hyperoxia. Am J Obstet Gynecol. 1964;90:854–858.

    PubMed  CAS  Google Scholar 

  34. Ferm VH. Teratogenic Effects of Hyperbaric Oxygen. Proc Soc Exp Biol Med. 1964;116:975–976.

    PubMed  CAS  Google Scholar 

  35. Nunn JF, Sharer NM, Bottiglieri T, Rossiter J. Effect of short-term administration of nitrous oxide on plasma concentrations of methionine, tryptophan, phenylalanine and S-adenosyl methionine in man. Br J Anaesth. 1986;58(1):1–10.

    Article  PubMed  CAS  Google Scholar 

  36. Lumb M, Sharer N, Deacon R, et al. Effects of nitrous oxide-induced inactivation of cobalamin on methionine and S-adenosylmethionine metabolism in the rat. Biochim Biophys Acta. 20 1983;756(3):354–359.

    PubMed  CAS  Google Scholar 

  37. Skacel PO, Hewlett AM, Lewis JD, Lumb M, Nunn JF, Chanarin I. Studies on the haemopoietic toxicity of nitrous oxide in man. Br J Haematol. 1983;53(2):189–200.

    Article  PubMed  CAS  Google Scholar 

  38. Keeling PA, Rocke DA, Nunn JF, Monk SJ, Lumb MJ, Halsey MJ. Folinic acid protection against nitrous oxide teratogenicity in the rat. Br J Anaesth. 1986;58(5):528–534.

    Article  PubMed  CAS  Google Scholar 

  39. Mazze RI, Wilson AI, Rice SA, Baden JM. Reproduction and fetal development in rats exposed to nitrous oxide. Teratology. 1984;30(2):259–265.

    Article  PubMed  CAS  Google Scholar 

  40. Mazze RI, Fujinaga M, Baden JM. Reproductive and teratogenic effects of nitrous oxide, fentanyl and their combination in Sprague-Dawley rats. Br J Anaesth. 1987;59(10):1291–1297.

    Article  PubMed  CAS  Google Scholar 

  41. Mazze RI, Fujinaga M, Rice SA, Harris SB, Baden JM. Reproductive and teratogenic effects of nitrous oxide, halothane, isoflurane, and enflurane in Sprague-Dawley rats. Anesthesiology. 1986;64(3):339–344.

    Article  PubMed  CAS  Google Scholar 

  42. Fujinaga M, Baden JM, Suto A. Preventive effects of phenoxybenzamine on N2O induced reproductive toxicity in Sprague-Dawley rats (abstract). Anesthesiology. 1990;73:920.

    Google Scholar 

  43. Aldridge LM, Tunstall ME. Nitrous oxide and the fetus. A review and the results of a retrospective study of 175 cases of anaesthesia for insertion of Shirodkar suture. Br J Anaesth. 1986;58(12):1348–1356.

    Article  PubMed  CAS  Google Scholar 

  44. O’Leary G, Bacon CL, Odumeru O, et al. Antiproliferative actions of inhalational anesthetics: comparisons to the valproate teratogen. Int J Dev Neurosci. 2000;18(1):39–45.

    Article  PubMed  Google Scholar 

  45. Loepke AW, Soriano SG. An assessment of the effects of general anesthetics on developing brain structure and neurocognitive function. Anesth Analg. 2008;106(6):1681–1707.

    Article  PubMed  Google Scholar 

  46. Jevtovic-Todorovic V, Hartman RE, Izumi Y, et al. Early exposure to common anesthetic agents causes widespread neurodegeneration in the developing rat brain and persistent learning deficits. J Neurosci. 2003;23(3):876–882.

    PubMed  CAS  Google Scholar 

  47. Jevtovic-Todorovic V, Olney JW. PRO: anesthesia-induced developmental neuroapoptosis: status of the evidence. Anesth Analg. 2008;106(6):1659–1663.

    Article  PubMed  Google Scholar 

  48. Rizzi S, Carter LB, Ori C, Jevtovic-Todorovic V. Clinical anesthesia causes permanent damage to the fetal guinea pig brain. Brain Pathol. 2008;18(2):198–210.

    Article  PubMed  Google Scholar 

  49. Bhavani-Shankar K, Steinbrook RA, Brooks DC, Datta S. Arterial to end-tidal carbon dioxide pressure difference during laparoscopic surgery in pregnancy. Anesthesiology. 2000;93(2):370–373.

    Article  PubMed  CAS  Google Scholar 

  50. O’Rourke N, Kodali BS. Laparoscopic surgery during pregnancy. Curr Opin Anaesthesiol. 2006;19(3):254–259.

    Article  PubMed  Google Scholar 

  51. Steinbrook RA, Bhavani-Shankar K. Hemodynamics during laparoscopic surgery in pregnancy. Anesth Analg. 2001;93(6):1570–1571, table of contents.

    Article  PubMed  CAS  Google Scholar 

  52. Gregory GA, Wade JG, Beihl DR, Ong BY, Sitar DS. Fetal anesthetic requirement (MAC) for halothane. Anesth Analg. 1983;62(1):9–14.

    Article  PubMed  CAS  Google Scholar 

  53. Moise KJ, Jr., Carpenter RJ, Jr., Deter RL, Kirshon B, Diaz SF. The use of fetal neuromuscular blockade during intrauterine procedures. Am J Obstet Gynecol. 1987;157(4 Pt 1):874–879.

    PubMed  Google Scholar 

  54. Silva V, Tsen LC, Wilkins-Haug L, Kodali BS. A Womb with a view: anesthetic, obstetric, and neonatal care issues for in-utero fetal surgery. Anesthesiology. 2006;104(Supp):A12.

    Google Scholar 

  55. Levinson G, Shnider SM. Anesthesia for Obstetrics. Baltimore: Williams & Wilkins; 1987:188.

    Google Scholar 

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Correspondence to Sanjay Datta .

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Datta, S., Kodali, B.S., Segal, S. (2010). Anesthesia for Nonobstetric Surgery During Pregnancy. In: Obstetric Anesthesia Handbook. Springer, New York, NY. https://doi.org/10.1007/978-0-387-88602-2_17

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  • DOI: https://doi.org/10.1007/978-0-387-88602-2_17

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