Anaesthetic agents in pregnant women undergoing non-obstetric surgical or endoscopic procedures

TITLE: Anaesthetic Agents in Pregnant Women Undergoing Non-Obstetric Surgical or Endoscopic Procedures: A Review of the Safety and Guidelines DATE: 8 June 2015 CONTEXT AND POLICY ISSUES It has been estimated that up to 2% of pregnant women require non-obstetric surgery that may be performed during any trimester of their pregnancy.1-4 Depending on the type of surgery and condition of the patient, [...] The purpose of this report is to review the clinical evidence and evidence-based guidelines regarding the safety of anaesthesia in pregnant women undergoing non-obstetric surgical or endoscopic procedures. [...] Critical Appraisal of Individual Studies The included systematic review was critically appraised using AMSTAR,5 the non-randomized study was evaluated using the Downs and Black checklist,6 and the guideline was assessed with the AGREE II instrument.7 Summary scores were not calculated for the included studies; rather, a review of the strengths and limitations of each included study were described [...] The risk of including inevitably nonviable pregnancies in the retrospective chart review was reduced by excluding patients that had a record of pre-surgical vaginal bleeding or an absence of a fetal heartbeat on ultrasonography.9 The ASGE guideline10 is relevant to pregnant women in any trimester of pregnancy and lactating women undergoing gastrointestinal endoscopy. [...] The ASGE guideline10 provides recommendations for the provision of anaesthesia and suggested agents for endoscopy of pregnant and lactating women.