As the applications of laparoscopy for general surgical procedures expanded
in the 1990s, pregnancy was initially considered a contraindication. Sever
al case reports have suggested the safety of laparoscopy in pregnancy. Prev
ious clinical studies indicate a higher fetal mortality may exist and advis
ed caution. To evaluate the fetal outcome of laparoscopic procedures in pre
gnant patients at our institution, we retrospectively reviewed the medical
records between 1991 and 1997 and identified 21 pregnant patients who under
went either a laparoscopic (n = 12) or open (n = 9) procedure. Appendectomi
es, cholecystectomies, and diagnostic laparoscopies were performed. Specifi
c variables including age, length of procedure, hospital stay, duration of
parenteral analgesic use, gestational age at the time of surgery and delive
ry, O-2 saturation and EtCO2 during surgery, APGAR scores, and birth weight
s were compared between the two groups. Laparoscopic procedures during preg
nancy resulted in shorter hospital stays (34 hours versus 91 hours; P = 0.0
1), less use of parenteral narcotic analgesics (5 hours versus 29 hours; P
= 0.05), and no prolongation of operative times (51 minutes versus 63 minut
es; P = 0.20). In addition, laparoscopy was performed at earlier gestationa
l ages (12 weeks versus 29 weeks; P = 0.001). There was one miscarriage 7 d
ays after a laparoscopic cholecystectomy early in the Ist trimester that wa
s not statistically significant. Our experience did not show a higher incid
ence of fetal loss when comparing laparoscopic to open procedures in pregna
nt patients.