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Obstetrics and Gynegology2024№1
Perioperative management of pregnant women...

Perioperative management of pregnant women in non-obstetric surgery

DOI
https://dx.doi.org/10.18565/aig.2023.147

Nitchenko A.V., Troshin P.V., Pyregov A.V., Kozachenko I.F. Belov A.V., Filippovich G.V., Pismensky S.V.

1) Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia; 2) Moscow Regional Perinatal Center, Moscow Region, Balashikha, Russia

Up to 2% of pregnant women undergo surgery for non-obstetric conditions all over the world. Anesthesiologists face the problem of providing anesthesia for pregnant women. Ideal anesthetics or methods for pregnant women should be safe and effective for mothers; they should not have a negative short- and long-term effect on the fetus, the normal course of pregnancy and childbirth. In recent years, the neurotoxic effects of anesthetics on the immature nervous system of the fetus have been actively studied.
Laparoscopic surgery offers benefits for both pregnant and non-pregnant women. Numerous reports provide the data showing the absence of adverse effects on the fetus during laparoscopy and gas pressure in the abdominal cavity of 12 mm Hg. However, it has been shown that non-obstetric operations, in particular bariatric, before pregnancy, as well as surgical interventions during pregnancy increase the risk of cesarean section. Changes in the maternal physiology can affect both the pharmacokinetics and the pharmacodynamics of muscle relaxants. This review presents the data on the improvement of anesthesiologic support and management of pregnant women in the postoperative period.
Conclusion: Surgical treatment of pregnant women is rather a safe procedure for the mother and fetus. The data on providing anesthesia for pregnant women in non-obstetric surgery are updated annually, and safety issues of using medications are more considered in terms of neurotoxicity than in terms of teratogenicity.

Authors’ contributions: Nitchenko A.V., Troshin P.V. – developing the concept of the article, searching and analyzing literature data, writing the text; Pyregov A.V., Kozachenko I.F. – developing the concept of the article, designing the work, editing the text, making key edits and forming the list of references, approving the final version of the article; Belov A.V., Filippovich G.V., Pismensky S.V. – text edition, making key edits.
Conflicts of interest: The authors declare no conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Nitchenko A.V., Troshin P.V., Pyregov A.V., Kozachenko I.F., Belov A.V., Filippovich G.V., Pismensky S.V. 
Perioperative management of pregnant women in non-obstetric surgery.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (1): 12-18 (in Russian)
https://dx.doi.org/10.18565/aig.2023.147

Keywords

pregnancy
anesthetic management
Full text (in Russian)

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Received 13.06.2023

Accepted 15.12.2023

About the Authors

Anastasiya V. Nitchenko, graduate student, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(495)438-77-77, nosferas95@mail.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.
Pavel V. Troshin, anesthesiologist-resuscitator, Assistant at the Department of Anesthesiology and Resuscitation, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(495)438-77-77, p_troshin@oparina4.ru, 117997, Russia, Moscow, Ac. Oparin str., 4,
https://orcid.org/0000-0002-4904-7913
Aleksey V. Pyregov, Dr. Med. Sci., Professor, Deputy Chief Physician Moscow Regional Perinatal Center, +7(916)140-65-49, Pyregov@mail.ru, 143900, Russia, Moscow region, Balashikha, Enhtusiasts shosse, 12, https://orcid.org/0000-0001-8382-9671
Irena F. Kozachenko, Dr. Med. Sci., Leading Researcher, Department of Operative Gynecology, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(495)438-77-77, i_kozachenko@oparina4.ru, 117997, Russia, Moscow, Ac. Oparin str., 4,
https://orcid.org/0000-0003-1822-9164
Alexander V. Belov, PhD, Associate Professor at the Department of Anesthesiology and Resuscitation, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(495)438-77-77, a_belov@oparina4.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.
Gennadiy V. Filippovitch, anesthesiologist-resuscitator, Assistant at the Department of Anesthesiology and Resuscitation, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(495)438-77-77, g_filippovitch@oparina4.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.
Sergey V. Pismensky, anesthesiologist-resuscitator, Assistant at the Department of Anesthesiology and Resuscitation, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, +7(906)652-92-09, smsu@mail.ru, 117997, Russia, Moscow, Ac. Oparin str., 4.

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