Non-Obstetric Surgery Flashcards
How do you counsel a patient about the risks of anesthesia during pregnancy?
- there is no evidence that in-utero exposure to anesthetics has any effect on the developing brain of the fetus
- there is no anesthetic agent with known teratogenic effects in humans when used at standard concentration at any gestational age
Do you perform continuous fetal monitoring during surgery?
- can assist in maternal positioning and cardiopulmonary management
- can be considered if fetus is viable, physically possible during procedure, presence of OB with privileges and personnel able to translate the monitoring result and c-section consent obtained prior to delivery
How do you counsel a patient about whether fetal monitoring should be performed during surgery in pregnancy?
- can be considered if fetus is viable, physically possible during procedure, presence of OB with privileges and personnel able to translate the monitoring result and c-section consent obtained prior to delivery
What issues do you take into consideration when making a decision as to whether or not to perform fetal monitoring during surgery in pregnancy?
Is the nature of surgery safe for interruption or alteration to allow for an emergency c-section?
What are the risks of abdominal surgery during pregnancy?
Damage to surrounding organs, blood loss, infection, preterm contractions
If continuous monitoring is not planned, how do you assess the fetus pre and postoperatively during surgery in the first trimester?
Doppler
If continuous monitoring is not planned, how do you assess the fetus pre and postoperatively during surgery in the second trimester?
- doppler
- patient / shared decision making in periviable state
If continuous monitoring is not planned, how do you assess the fetus pre and postoperatively during surgery in the third trimester?
Non stress testing preoperatively and postoperatively
