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Chapter 16 - Surgery in Pregnancy

from Part III - SURGICAL PROCEDURES

Published online by Cambridge University Press:  07 May 2010

John Patrick O'Grady
Affiliation:
Tufts University, Massachusetts
Reinaldo Figueroa
Affiliation:
Clinical Associate Professor, Department of Obstetrics, Gynecology and Reproductive Medicine State University of New York at Stony Brook
J. Gerald Quirk
Affiliation:
Professor and Chair, Department of Obstetrics, Gynecology, and Reproductive Medicine State University of New York at Stony Brook
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Summary

This chapter considers selected aspects of surgical technique, complications, and the management of some surgical problems that develop in association with pregnancy. The signs and symptoms of various surgical conditions are modified by the anatomic and physiologic changes that accompany pregnancy, paradoxically often resulting in their exacerbation, an apparent reduction in intensity, or a change in the location of the expected physical signs. Impaired healing and wound infections are among the most common complications of surgery, in pregnant as in nonpregnant patients. During abdominal surgery, iatrogenic injuries commonly involve the gastrointestinal and urinary tracts. Surgical complications involve gallbladder disease and appendicitis. The chapter discusses a series of neoplastic disorders encountered at varying degrees of frequency during pregnancy, and outlines their clinical management. In areas of developing surgical techniques, the most significant area of legal exposure falls in the lag between actual practice and the establishment of accepted safeguards.

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