Evaluation of safety and foeto‐maternal outcome following non‐obstetric surgery in pregnancy: a retrospective single‐site Australian study

We conducted a retrospective study to evaluate the safety of non‐obstetric surgery during pregnancy by studying 106 pregnant women who underwent non‐obstetric surgery at a regional Australian hospital over a 10‐year period. The study showed that maternal and foetal outcomes were comparable to that of the general population. Subgroup analysis did not demonstrate any statistically significant differences between groups, except for an increased rate of delivery by caesarean section in pregnant women who underwent laparotomy compared to those who underwent laparoscopy. Background Existing data on safety of non‐obstetric surgery during pregnancy appear limited and conflicting. This study aimed to assess perinatal outcomes and complications in pregnant women undergoing non‐obstetric surgeries. Methods A single‐site Australian study was performed utilizing a 10‐year data (2009–2018) collected retrospectively. Descriptive statistics were used to summarize the characteristics of the study population. Statistical analyses between groups were conducted by independent t‐test or Mann–Whitney (for means between groups) and by chi‐squared/Fisher's exact test (for categorical variables). Results A total of 108 pregnant women underwent non‐obstetric surgery, with an increasing trend in annual numbers since 2014. The majority of women (91%) underwent surgeries as an emergency procedure, and under general anaesthesia (69.8%). Procedures during the first trimester comprised 45%, making it the most common trimester for non‐obstetric surgeries. The most common cause for surgery arose in the gastrointestinal/digestive tract (39%). Overall perinatal complication rate was 19% with the rate of miscarriage/foetal loss, preterm birth and intrauterine growth restriction/small for gestational age being 4.7%, 10.4% and 3.8%, respectively. A total of 46 patients underwent intra‐abdominal surgery. The most common surgery in the laparoscopy group was appendicectomy (56%), whereas adnexal pathology (54%) contributed to the majority of laparotomies. Subgroup comparison showed no significant difference in perinatal outcomes except for caesarean delivery rate (24% versus 67% for laparoscopy versus open, respectively (P = 0.04)). Conclusion With an overall perinatal complication rate of 19%, the rate of adverse perinatal outcomes following non‐obstetric surgery during pregnancy in our study was low and comparable to those of the general population.