1) Having surgery while pregnant
During pregnancy, surgery may be necessary for a number of reasons. These surgeries may be related to pregnancy or may be related to different diseases that have nothing to do with pregnancy. At the same time, it is possible to divide these surgeries into two separate groups: urgent and planned.
2) Surgeries related to pregnancy
Stitching the cervix (cervical cerclage), ectopic pregnancy surgery, cesarean section… Myoma surgeries, ovarian torsion surgeries, pelvic abscess surgeries are some examples of gynecological diseases.
3) Surgeries not related to pregnancy
The most commonly performed surgery during pregnancy is appendectomy. Apart from this, many surgeries such as stomach perforation (hole), intestine, hemorrhoids (piles), gallbladder can be performed on the expectant mother. There are also surgeries that must be performed in emergency situations even though the pregnancy is present. These are surgeries such as traffic accidents, trauma, injuries caused by sharp objects, gunshot wounds, fractures, orthopedic and brain surgery surgeries. Approximately 1% to 2% of pregnant women need surgery during pregnancy for a reason unrelated to pregnancy.
4) Is it risky to have surgery during pregnancy?
Surgery performed during pregnancy may have various risks for the mother and the baby. Of course, this is a risk that varies depending on the type of surgery performed and the stage of pregnancy. There is a risk of miscarriage in surgical operations performed in the first 3 months of pregnancy. There is also a risk of premature birth in surgeries performed in the last 3 months of pregnancy. For this reason, the most preferred period for non-emergency planned surgeries is the middle 3 months of pregnancy, namely the 4th, 5th, and 6th months. The type of surgery also plays an important role in terms of risk. For example, an appendectomy carries a higher risk than a hemorrhoid surgery. Minor surgeries that do not involve the abdominal area carry less risk for pregnancy.
Surgeries performed during pregnancy are performed with local anesthesia, general anesthesia, or spinal anesthesia. This depends on the condition of the surgery and the disease. At the same time, some surgical operations are performed laparoscopically (closed method). For example; appendicitis surgery, gallbladder surgery, ovarian cyst surgery.
In summary, surgery is not performed during pregnancy unless it is necessary and is postponed until after birth. If it does not seem possible to postpone the surgery until after birth, it can be waited until the end of the first 3 months and is performed in the 4th, 5th, and 6th months to reduce the risk. However, some surgeries cannot be postponed at all. In such cases, the surgery is performed after the need for surgery and the risks it may create on the pregnancy are shared with the family.
5) If surgery is necessary during pregnancy, what time should it be?
During pregnancy, sometimes due to pregnancy-related reasons and sometimes due to problems that occur outside of pregnancy, surgical operations may be required. Planned operations are generally postponed until after the first trimester. In surgeries performed within the first 3 months, there is concern that anesthetics may harm the baby. The second trimester is considered a safe interval. Cerclage (stitching the cervix), which should be applied during early pregnancy, is generally performed at the end of the first trimester. This also covers the risk-free period. However, overtorsion (rotation of the ovary around its own stalk), which has an increased risk due to the ovary being enlarged more than expected in in vitro fertilization treatments, is a condition that requires emergency surgery. It should not be operated on immediately, even within the first 3 months of pregnancy. In such cases, it has been observed that the pregnancy generally continues without any problems after the surgeries performed.
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