LAPAROSCOPIC SURGERY DURING PREGNANCY

BACKGROUND: Animal studies have demonstrated fetal acidosis during car bon dioxide pneumoperitoneum. This finding suggests a potential advers e effect of CO2 pneumoperitoneum on fetal outcome in humans. PATIENTS AND METHODS: We reviewed our recent experience with laparoscopic surge ry performed under general anesthesia and with the use of CO2 pneumope ritoneum, in pregnant women with appendicitis or cholecystitis. We com pared these women's charts and pregnancy outcomes with those of pregna nt women who underwent formal laparotomy during the same period of tim e. RESULTS: Seven pregnant patients underwent laparoscopic surgery, an d there were 4 fetal deaths among them (3 during the first postoperati ve week, and another 4 weeks postoperatively). Five pregnant patients underwent formal laparotomy, of whom 4 subsequently progressed to term and 1 was lost to follow-up. CONCLUSIONS: Our recent experiences toge ther with the available animal data suggest that caution should be use d when considering nonobstetrical laparoscopic surgery in pregnant wom en. This experience suggests that additional clinical and laboratory i nvestigations may be indicated to evaluate fetal risk associated with such surgery.