Whenever a pregnant woman undergoes nonobstetric surgery, consultations among her obstetrical team, surgeons, anesthesiologists, and neonatologists are important to coordinate management. In general, a pregnant woman should never be denied oncological surgery regardless of trimester. Surgery should be done at an institution with a neonatal and a pediatric service, an obstetrics care provider with cesarean delivery privileges should be readily available, and a qualified team should be promptly available to interpret any fetal changes. Pregnant patients who require cancer surgery should be evaluated preoperatively in the same manner as nonpregnant patients. Additional testing is not indicated in an uncomplicated pregnancy. Patients should be reassured that surgery and anesthesia can be performed with minimal risks which are not clearly increased compared to pregnancy without surgery in terms of miscarriage and malformation. However, it is prudent to minimize exposure of the fetus to surgery and medication during pregnancy and to protect the woman from risk of aspiration, difficult intubation, thromboembolism, and infections.
ASJC Scopus subject areas