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. Depending on the type of surgery and condition of the patient, non-obstetric surgery may be performed using multiple options for anesthetic agents for general anaesthesia (GA) or regional anaesthesia (RA). However, anaesthesia may present risks to both the mother and the fetus by increasing the potential for maternal and fetal hypoxia, adverse impact on fetal development, or loss of pregnancy. For this reason, proper anaesthesia management of the pregnant patient is particularly sensitive. To inform clinical practice decisions, it is important to identify whether certain anaesthetic agents or drugs are safer than others for use during surgery on pregnant patients, particularly during early pregnancy or in cases when the patient does not yet know she is pregnant.

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.

Contents

• CONTEXT AND POLICY ISSUES
• RESEARCH QUESTIONS
• KEY FINDINGS
• METHODS
  • Literature Search Methods
  • Selection Criteria and Methods
  • Exclusion Criteria
  • Critical Appraisal of Individual Studies
• SUMMARY OF EVIDENCE
  • Quantity of Research Available
  • Summary of Study Characteristics
  • Summary of Critical Appraisal
  • Summary of Findings
  • Limitations
• CONCLUSIONS AND IMPLICATIONS FOR DECISION OR POLICY MAKING
• REFERENCES
• APPENDIX 1 Selection of Included Studies
• APPENDIX 2 Characteristics of Included Publications
• APPENDIX 3 Critical Appraisal of Included Publications
• APPENDIX 4 Main Study Findings and Guideline Recommendations
• APPENDIX 5 Additional References of Potential Interest

Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic that CADTH could identify using all reasonable efforts within the time allowed. Rapid responses should be considered along with other types of information and health care considerations. The information included in this response is not intended to replace professional medical advice, nor should it be construed as a recommendation for or against the use of a particular health technology. Readers are also cautioned that a lack of good quality evidence does not necessarily mean a lack of effectiveness particularly in the case of new and emerging health technologies, for which little information can be found, but which may in future prove to be effective. While CADTH has taken care in the preparation of the report to ensure that its contents are accurate, complete and up to date, CADTH does not make any guarantee to that effect. CADTH is not liable for any loss or damages resulting from use of the information in the report.