Safety and Foeto-Maternal Outcomes Following Emergency Laparoscopic Surgery in Pregnancy: A Systematic Review

Akrami, Mahdis; Alizadeh, Roghayeh; Aliyari Boroujeni, Sima; Abbasi, Fateme

doi:10.30491/tm.2025.548668.1880

Safety and Foeto-Maternal Outcomes Following Emergency Laparoscopic Surgery in Pregnancy: A Systematic Review

Document Type : Systematic Review

Authors

Mahdis Akrami

Roghayeh Alizadeh

Sima Aliyari Boroujeni

Fateme Abbasi

Department of gynecology, Kermanshah University of medical sciences, Kermanshah, Iran.

10.30491/tm.2025.548668.1880

Abstract

Introduction: Common causes of non-obstetric surgeries include appendicitis, cholecystitis, and adnexal issues during pregnancy. This review study aims to assess various outcomes of laparoscopic surgery in pregnant women.
Method: We searched databases like MEDLINE, EMBASE, CINAHL, and the Cochrane Library, focusing on studies published between January 2010 and August 2025. We included studies reporting laparoscopic surgeries in pregnant women, specifically those involving more than 10 patients. We gathered data on patient demographics, the type of surgery performed, the trimester, and details of the operation, maternal outcomes, and rates of fetal loss, incidences of preterm birth, and other complications. Due to differences across studies, we performed a narrative synthesis of the findings.
Result: The majority of these procedures were appendectomies, cholecystectomies, or surgeries for adnexal pathologies. Overall, maternal outcomes were positive, with less than 1% experiencing major complications and no maternal deaths. Conversion to open surgery occurred in 0-5% of cases. The fetal loss rate was reported between 0 to 8%; usually, it was higher in cases of complicated appendicitis, while preterm birth was reported between 2 and 10% of cases. Notably, there was no significant rise in fetal anomalies, and the best outcomes were typically associated with surgeries performed during the second trimester.
Conclusion: According to the outcomes, laparoscopic surgery during pregnancy generally carries a low risk for both mothers and their babies. Most women experience minimal complications, and the outcomes for the fetus are usually positive, mainly when the surgery occurs during the second trimester. It’s crucial to have careful monitoring and skilled surgical practices in place to help ensure a smooth, safe experience for both mother and child.

Keywords

Laparoscopy

Pregnancy

Appendectomy

Cholecystectomy

Adnexal Surgery

Subjects