Gebelik Döneminde Cerrahi Hastalıklar, Uygulamalar ve Girişimler
Özet
Gebelikte cerrahi hastalıklar nadir görülmekle birlikte, bazı durumlarda cerrahi girişimler zorunlu hale gelebilmektedir. Anne ve fetüsün güvenliği öncelikli olup, cerrahi müdahale multidisipliner bir yaklaşımla planlanmalıdır. Gebelikte cerrahi uygulamaların ikinci trimesterde yapılması anne ve fetüs sağlığı açısından daha az risklidir. Anestezi yönetimi, ameliyat sonrası bakım, analjezi ve tromboembolizm profilaksisi dikkatle uygulanmalıdır. Ebe ve hemşireler, anneye hem fiziksel hem de psikolojik destek sunarak olası komplikasyonları izlemelidir. Ayrıca, gebeyi bilgilendirip cerrahi sürece adapte olmalarına yardımcı olunmalıdır. Cerrahi operasyon sürecinde gebe ile şeffaf bir iletişim kurulması, operasyonun başarısını ve iyileşme sürecini destekler.
Referanslar
Özşaker E, Dinç G, Soğukpınar N. Gebelikle İlgili Olmayan Cerrahi; Gebe Hastanın Bakımı. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi. 2015; 8(2): 101-107.
ACOG Committee Opinion. Nonobstetric Surgery During Pregnancy. Obstetrics & Gynecology. 2019; 133(4): e285-e286. doi:10.1097/AOG.0000000000003180
Dinç G, Soğukpınar N, Özşeker E. Gebelikte Gebelikle İlgili Olmayan Cerrahi Girişimler. Türkiye Klinikleri J Health Sci. 2016; 1(3).
Rasmussen AS, Christiansen CF, Uldbjerg N, Nørgaard M. Obstetric and non-obstetric surgery during pregnancy: A 20-year Danish population-based prevalence study. BMJ Open. 2019; 9(5): e028136. doi:10.1136/bmjopen-2018-028136.
Haataja A, Kokki H, Uimari O, Kokki M. Non-obstetric surgery during pregnancy and the effects on maternal and fetal outcomes: A systematic review. Scand J Surg. 2023; 112(3): 187-205. doi:10.1177/14574969231175569.
Auron M, Duran Castillo MY, Garcia OFD. Perioperative management of pregnant women undergoing nonobstetric surgery. Cleve Clin J Med. 2021; 88(1): 27-34. doi:10.3949/ccjm.88a.18111.
Erekson EA, Brousseau EC, Dick-Biascoechea MA, et al. Maternal postoperative complications after nonobstetric antenatal surgery. J Matern Fetal Neonatal Med. 2012; 25(12): 2639-2644. doi:10.3109/14767058.2012.704445.
Huang SY, Lo PH, Liu WM, et al. Outcomes after nonobstetric surgery in pregnant patients: a nationwide study. Mayo Clin Proc. 2016; 91(9): 1166-1172. doi:10.1016/j.mayocp.2016.06.021.
Jackson H, Grange S, Price R, et al. Diagnosis and laparoscopic treatment of surgical diseases during pregnancy: an evidence-based review. Surg Endosc. 2008; 22: 1917-1927. doi:10.1007/s00464-008-9989-6.
Stewart MK, Terhune KP. Management of pregnant patients undergoing general surgical procedures. Surg Clin North Am. 2015; 95(2): 429-442. doi:10.1016/j.suc.2014.10.007.
Gangakhedkar GR, Kulkarni AP. Physiological Changes in Pregnancy. Indian J Crit Care Med. 2021; 25(Suppl 3): S189-S192. doi:10.5005/jp-journals-10071-24039.
Özer N. Cerrahi ve Cerrahi Hemşireliğinin Tarihçesi Cerrahinin Sınıflandırılması Cerrahi Gerektiren Durumlar Hasta Üzerindeki Etkileri. İçinde: Aslan FE, ed. Cerrahi Bakım Vaka Analizleri ile Birlikte (s. 4-36). Ankara: Akademisyen Tıp Kitabevi; 2016.
Dhamecha R, Pajai S, Bhasin T. Acute Abdomen in Pregnancy: A Comprehensive Review of Diagnosis and Management. Cureus. 2023; 15(6): e40679. doi:10.7759/cureus.40679.
Brent RL. Saving lives and changing family histories: appropriate counseling of pregnant women and men and women of reproductive age, concerning the risk of diagnostic radiation exposures during and before pregnancy. Am J Obstet Gynecol. 2009; 200(1): 4-24. doi:10.1016/j.ajog.2008.06.032.
Patel SJ, Reede DL, Katz DS, Subramaniam R, Amorosa JK. Imaging the pregnant patient for nonobstetric conditions: algorithms and radiation dose considerations. Radiographics. 2007; 27(6): 1705-1722. doi:10.1148/rg.276075002.
American College of Obstetricians and Gynecologists (ACOG). Guidelines for Diagnostic Imaging During Pregnancy. ACOG Official Publications. 2017. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/10/guidelines-for-diagnostic-imaging-during-pregnancy-and-lactation
Wiles R, Hankinson B, Benbow E, Sharp A. Making decisions about radiological imaging in pregnancy. BMJ. 2022; 377: e070486. doi:10.1136/bmj-2022-070486.
Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, Spong CY. Williams Obstetrics. 25th ed. New York: McGraw-Hill Education; 2018.
Morrison MA, Chung Y, Heneghan MA. Managing hepatic complications of pregnancy: practical strategies for clinicians. BMJ Open Gastroenterol. 2022; 9(1): e000624. doi:10.1136/bmjgast-2021-000624.
Öksüz G, Gişi G, Urfalıoğlu A, Arslan M, Tekşen Ş, Boran ÖF, Öksüz H. Apendektomi Yapılan Gebe Hastalarda Anestezi Yönetimi. Zeynep Kamil Tıp Bülteni. Nisan 2018;49(1):130-132. doi:10.16948/zktipb.335546
Karahalil B. Prenatal Dönemde İlaç Kullanımı ve Teratojenite Riski. Turkiye Klinikleri J Med GenetSpecial Topics 2018;3(1):97-108.
Şahin H, Erbaş M, Toman H, Kiraz HA, Ömür D, Arık MA, et al. Yirmisekiz haftalık gebede non-obstetrik cerrahi ve anestezi yönetimi. Anatolian J Clin Invest. 2014; 8(1): 36-38.
Williams PM, Fletcher S. Health effects of prenatal radiation exposure. Am Fam Physician. 2010; 82(5): 488-493.
Croke L. Caring for Pregnant Patients Undergoing Nonobstetric Surgery. AORN J. 2023; 117(4): P6-P8. doi:10.1002/aorn.13908.
Okeagu CN, Anandi P, Gennuso S, et al. Clinical management of the pregnant patient undergoing non-obstetric surgery: Review of guidelines. Best Pract Res Clin Anaesthesiol. 2020; 34(2): 269-281. doi:10.1016/j.bpa.2020.05.005.
Zeleke ME, Chekol WB, Kasahun HG, et al. Perioperative management of surgical procedure during pregnancy: a systematic review. Ann Med Surg (Lond). 2024; 86(6): 3432-3441. doi:10.1097/MS9.0000000000002057.
Wilson RD, Caughey AB, Wood SL, et al. Guidelines for Antenatal and Preoperative Care in Cesarean Delivery: Enhanced Recovery After Surgery Society Recommendations (Part 1). Am J Obstet Gynecol. 2018; 219(6): 523.e1-523.e15. doi:10.1016/j.ajog.2018.09.015.
Brakke BD, Sviggum HP. Anaesthesia for non-obstetric surgery during pregnancy. BJA Educ. 2023; 23(3): 78-83. doi:10.1016/j.bjae.2022.12.001.
Demir Karakılıç İ, Uslu Yuvacı H, Özden S. Gebelikte Hipertansif Hastalıkların Tanısı ve Yöntemi. Journal of Human Rhythm. Mart 2018;4(1):1-8.
Sturgeon TE, Ayaz H, McCrorie K, Stewart K. Informed consent in obstetrics - a survey of pregnant women to set a new standard for consent in emergency obstetric interventions. J Obstet Gynaecol. 2021; 41(4): 541-545. doi:10.1080/01443615.2020.1755624.
Upadya M, Saneesh PJ. Anaesthesia for non-obstetric surgery during pregnancy. Indian J Anaesth. 2016; 60(4): 234-241. doi:10.4103/0019-5049.179445.
Barnett V, Bartalot AN, Nezhat CH. Operating Room Setup and Patient Positioning for Non-obstetric Surgery During Pregnancy. İçinde: Nezhat C, Kavic M, Lanzafame R, Lindsay M, Polk T, eds. Non-Obstetric Surgery During Pregnancy (s. 5-19). Cham: Springer; 2019. doi:10.1007/978-3-319-90752-9_5.
Combs CA, Einerson BD, Toner LE, et al. Society for Maternal-Fetal Medicine Special Statement: Surgical safety checklists for cesarean delivery. Am J Obstet Gynecol. 2021;225(5): B43-B49. doi:10.1016/j.ajog.2021.07.011.
Işık Andsoy I, Özdemir M. Cerrahi hastasında cilt temizliğinde antiseptik ajan kullanımı: bir derleme. Unika Sağlık Bilimleri Dergisi, 2021; 1(1):28-38.
Caughey AB, Wood SL, Macones GA, et al. Guidelines for intraoperative care in cesarean delivery: Enhanced Recovery After Surgery Society Recommendations (Part 2). Am J Obstet Gynecol. 2018; 219(6): 533-544. doi:10.1016/j.ajog.2018.08.006.
Munnur U, de Boisblanc B, Suresh MS. Airway problems in pregnancy. Crit Care Med. 2005;33(10 Suppl):S259-S268. doi:10.1097/01.ccm.0000183502.45419.c9
Macones GA, Caughey AB, Wood SL, et al. Guidelines for postoperative care in cesarean delivery: Enhanced Recovery After Surgery (ERAS) Society recommendations (Part 3). Am J Obstet Gynecol. 2019; 221(3): 247.e1-247.e9. doi:10.1016/j.ajog.2019.04.012
ACOG Committee Opinion. Nonobstetric Surgery During Pregnancy. Obstetrics & Gynecology. 2019; 133(4): e285-e286. doi:10.1097/AOG.0000000000003180
Dinç G, Soğukpınar N, Özşeker E. Gebelikte Gebelikle İlgili Olmayan Cerrahi Girişimler. Türkiye Klinikleri J Health Sci. 2016; 1(3).
Rasmussen AS, Christiansen CF, Uldbjerg N, Nørgaard M. Obstetric and non-obstetric surgery during pregnancy: A 20-year Danish population-based prevalence study. BMJ Open. 2019; 9(5): e028136. doi:10.1136/bmjopen-2018-028136.
Haataja A, Kokki H, Uimari O, Kokki M. Non-obstetric surgery during pregnancy and the effects on maternal and fetal outcomes: A systematic review. Scand J Surg. 2023; 112(3): 187-205. doi:10.1177/14574969231175569.
Auron M, Duran Castillo MY, Garcia OFD. Perioperative management of pregnant women undergoing nonobstetric surgery. Cleve Clin J Med. 2021; 88(1): 27-34. doi:10.3949/ccjm.88a.18111.
Erekson EA, Brousseau EC, Dick-Biascoechea MA, et al. Maternal postoperative complications after nonobstetric antenatal surgery. J Matern Fetal Neonatal Med. 2012; 25(12): 2639-2644. doi:10.3109/14767058.2012.704445.
Huang SY, Lo PH, Liu WM, et al. Outcomes after nonobstetric surgery in pregnant patients: a nationwide study. Mayo Clin Proc. 2016; 91(9): 1166-1172. doi:10.1016/j.mayocp.2016.06.021.
Jackson H, Grange S, Price R, et al. Diagnosis and laparoscopic treatment of surgical diseases during pregnancy: an evidence-based review. Surg Endosc. 2008; 22: 1917-1927. doi:10.1007/s00464-008-9989-6.
Stewart MK, Terhune KP. Management of pregnant patients undergoing general surgical procedures. Surg Clin North Am. 2015; 95(2): 429-442. doi:10.1016/j.suc.2014.10.007.
Gangakhedkar GR, Kulkarni AP. Physiological Changes in Pregnancy. Indian J Crit Care Med. 2021; 25(Suppl 3): S189-S192. doi:10.5005/jp-journals-10071-24039.
Özer N. Cerrahi ve Cerrahi Hemşireliğinin Tarihçesi Cerrahinin Sınıflandırılması Cerrahi Gerektiren Durumlar Hasta Üzerindeki Etkileri. İçinde: Aslan FE, ed. Cerrahi Bakım Vaka Analizleri ile Birlikte (s. 4-36). Ankara: Akademisyen Tıp Kitabevi; 2016.
Dhamecha R, Pajai S, Bhasin T. Acute Abdomen in Pregnancy: A Comprehensive Review of Diagnosis and Management. Cureus. 2023; 15(6): e40679. doi:10.7759/cureus.40679.
Brent RL. Saving lives and changing family histories: appropriate counseling of pregnant women and men and women of reproductive age, concerning the risk of diagnostic radiation exposures during and before pregnancy. Am J Obstet Gynecol. 2009; 200(1): 4-24. doi:10.1016/j.ajog.2008.06.032.
Patel SJ, Reede DL, Katz DS, Subramaniam R, Amorosa JK. Imaging the pregnant patient for nonobstetric conditions: algorithms and radiation dose considerations. Radiographics. 2007; 27(6): 1705-1722. doi:10.1148/rg.276075002.
American College of Obstetricians and Gynecologists (ACOG). Guidelines for Diagnostic Imaging During Pregnancy. ACOG Official Publications. 2017. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2017/10/guidelines-for-diagnostic-imaging-during-pregnancy-and-lactation
Wiles R, Hankinson B, Benbow E, Sharp A. Making decisions about radiological imaging in pregnancy. BMJ. 2022; 377: e070486. doi:10.1136/bmj-2022-070486.
Cunningham FG, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, Spong CY. Williams Obstetrics. 25th ed. New York: McGraw-Hill Education; 2018.
Morrison MA, Chung Y, Heneghan MA. Managing hepatic complications of pregnancy: practical strategies for clinicians. BMJ Open Gastroenterol. 2022; 9(1): e000624. doi:10.1136/bmjgast-2021-000624.
Öksüz G, Gişi G, Urfalıoğlu A, Arslan M, Tekşen Ş, Boran ÖF, Öksüz H. Apendektomi Yapılan Gebe Hastalarda Anestezi Yönetimi. Zeynep Kamil Tıp Bülteni. Nisan 2018;49(1):130-132. doi:10.16948/zktipb.335546
Karahalil B. Prenatal Dönemde İlaç Kullanımı ve Teratojenite Riski. Turkiye Klinikleri J Med GenetSpecial Topics 2018;3(1):97-108.
Şahin H, Erbaş M, Toman H, Kiraz HA, Ömür D, Arık MA, et al. Yirmisekiz haftalık gebede non-obstetrik cerrahi ve anestezi yönetimi. Anatolian J Clin Invest. 2014; 8(1): 36-38.
Williams PM, Fletcher S. Health effects of prenatal radiation exposure. Am Fam Physician. 2010; 82(5): 488-493.
Croke L. Caring for Pregnant Patients Undergoing Nonobstetric Surgery. AORN J. 2023; 117(4): P6-P8. doi:10.1002/aorn.13908.
Okeagu CN, Anandi P, Gennuso S, et al. Clinical management of the pregnant patient undergoing non-obstetric surgery: Review of guidelines. Best Pract Res Clin Anaesthesiol. 2020; 34(2): 269-281. doi:10.1016/j.bpa.2020.05.005.
Zeleke ME, Chekol WB, Kasahun HG, et al. Perioperative management of surgical procedure during pregnancy: a systematic review. Ann Med Surg (Lond). 2024; 86(6): 3432-3441. doi:10.1097/MS9.0000000000002057.
Wilson RD, Caughey AB, Wood SL, et al. Guidelines for Antenatal and Preoperative Care in Cesarean Delivery: Enhanced Recovery After Surgery Society Recommendations (Part 1). Am J Obstet Gynecol. 2018; 219(6): 523.e1-523.e15. doi:10.1016/j.ajog.2018.09.015.
Brakke BD, Sviggum HP. Anaesthesia for non-obstetric surgery during pregnancy. BJA Educ. 2023; 23(3): 78-83. doi:10.1016/j.bjae.2022.12.001.
Demir Karakılıç İ, Uslu Yuvacı H, Özden S. Gebelikte Hipertansif Hastalıkların Tanısı ve Yöntemi. Journal of Human Rhythm. Mart 2018;4(1):1-8.
Sturgeon TE, Ayaz H, McCrorie K, Stewart K. Informed consent in obstetrics - a survey of pregnant women to set a new standard for consent in emergency obstetric interventions. J Obstet Gynaecol. 2021; 41(4): 541-545. doi:10.1080/01443615.2020.1755624.
Upadya M, Saneesh PJ. Anaesthesia for non-obstetric surgery during pregnancy. Indian J Anaesth. 2016; 60(4): 234-241. doi:10.4103/0019-5049.179445.
Barnett V, Bartalot AN, Nezhat CH. Operating Room Setup and Patient Positioning for Non-obstetric Surgery During Pregnancy. İçinde: Nezhat C, Kavic M, Lanzafame R, Lindsay M, Polk T, eds. Non-Obstetric Surgery During Pregnancy (s. 5-19). Cham: Springer; 2019. doi:10.1007/978-3-319-90752-9_5.
Combs CA, Einerson BD, Toner LE, et al. Society for Maternal-Fetal Medicine Special Statement: Surgical safety checklists for cesarean delivery. Am J Obstet Gynecol. 2021;225(5): B43-B49. doi:10.1016/j.ajog.2021.07.011.
Işık Andsoy I, Özdemir M. Cerrahi hastasında cilt temizliğinde antiseptik ajan kullanımı: bir derleme. Unika Sağlık Bilimleri Dergisi, 2021; 1(1):28-38.
Caughey AB, Wood SL, Macones GA, et al. Guidelines for intraoperative care in cesarean delivery: Enhanced Recovery After Surgery Society Recommendations (Part 2). Am J Obstet Gynecol. 2018; 219(6): 533-544. doi:10.1016/j.ajog.2018.08.006.
Munnur U, de Boisblanc B, Suresh MS. Airway problems in pregnancy. Crit Care Med. 2005;33(10 Suppl):S259-S268. doi:10.1097/01.ccm.0000183502.45419.c9
Macones GA, Caughey AB, Wood SL, et al. Guidelines for postoperative care in cesarean delivery: Enhanced Recovery After Surgery (ERAS) Society recommendations (Part 3). Am J Obstet Gynecol. 2019; 221(3): 247.e1-247.e9. doi:10.1016/j.ajog.2019.04.012
Sayfalar
25-42
Gelecek
14 Şubat 2025
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