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Non Obstetric Surgery in Pregnancy 





  • Pregnancy considerations (difficult intubation, aspiration, ↓ time to desaturation, aortocaval compression, 2 patients)

  • Maintenance of uteroplacental perfusion:

    • ​FHR monitoring when possible

    • Avoid hypoxemia, hypotension, acidosis

  • Risk of preterm labour:

    • Obstetrical consult with consideration of steroids for lung maturity & magnesium for brain protection 

  • Surgical considerations of a gravid uterus

  • Anesthetic drug effects on fetus (FHR changes, teratogenicity)



Goals & Conflicts


  • Delay nonelective surgery to the second trimester if possible

  • Optimize & maintain normal maternal physiologic function

  • Optimize & maintain uteroplacental blood flow & oxygen delivery (guided by FHR monitoring)

  • Preparations for preterm labour:

    • Fetal lung maturity

    • Availability of NICU

  • Avoid teratogens

  • Avoid stimulating the myometrium (oxytocic effects) to prevent preterm labour

  • Use regional anesthesia if possible

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