NON-OBSTETRIC ABDOMINAL SURGERY DURING PREGNANCY: A CONTEMPORARY PERSPECTIVE ON SAFETY AND OUTCOMES

Abstract

Non-obstetric abdominal surgery during pregnancy represents a complex clinical challenge requiring a multidisciplinary approach involving obstetricians-gynecologists, surgeons, and anesthesiologists. Physiological changes associated with pregnancy may mask the clinical manifestations of acute surgical conditions and complicate their timely diagnosis. In addition, limitations regarding the use of certain imaging modalities and medications create further challenges in selecting the optimal treatment strategy. The most common indications for surgical intervention include acute appendicitis, acute cholecystitis, adnexal pathology, intestinal obstruction, and other urgent conditions. Delaying necessary surgical treatment may result in severe maternal and perinatal complications, including septic conditions, preterm birth, fetal distress, and increased perinatal morbidity.

This review analyzes current literature regarding the diagnosis, anesthetic management, and surgical treatment of non-obstetric abdominal diseases during pregnancy. The advantages and limitations of both laparoscopic and open surgical approaches are discussed, along with specific considerations for patient management according to gestational age. Particular attention is given to current recommendations concerning the timing of surgical intervention, prevention of complications, and maintenance of maternal and fetal safety throughout the perioperative period. Contemporary evidence regarding the safety of anesthesia and laparoscopic procedures for both mother and fetus is summarized.

The analysis indicates that, when clinically indicated, timely surgical intervention is safe and is associated with more favorable outcomes compared with unjustified postponement of surgery. In most cases, laparoscopy may be considered the preferred surgical approach when performed according to current guidelines and by an experienced surgical team. Early diagnosis and an appropriate surgical strategy can minimize maternal and fetal risks and improve obstetric and perinatal outcomes.

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