Operations during pregnancy: what about anesthesia? What to expect if you have laparoscopy early in your baby's life

Often there are situations when a woman needs surgery either before or during pregnancy. Modern medicine has recently begun to use the methods of laparoscopy not only for diagnostics, but also for operations. And this cannot but rejoice, because after laparoscopic operations patients can walk the very next day.

How is laparoscopy performed?

This operation is minimally invasive and is done using specialized instruments and an endoscope, which are inserted into the abdominal cavity through small punctures. The indisputable advantages of the method are:

• low trauma (there is no need to leave large scars), and small holes heal quickly,
• insignificant blood loss, which is important,
• the ability to preserve organs that would have to be removed during a strip operation - you can better examine the organ by approaching it literally close to it, whereas with a strip operation the surgeon's eyes are approximately 50 cm from the organ,
• high speed of the operation in comparison with strip.

Gynecology

Specifically in gynecology, laparoscopy can replace 90 percent of all operations. With the help of this operation, you can diagnose an ectopic pregnancy in time, torsion of the appendages, treat endometriosis, eliminate adhesions or cysts, and much more. In addition, the procedure is more gentle for other organs, which are problematic to save during lane surgery.

Operation for a pregnant woman

As mentioned earlier, with the help of laparoscopy, it is possible to eliminate many diseases in gynecology, including after the onset of pregnancy, with minimal threat to the fetus. Thus, laparoscopy makes it possible to operate on uterine fibroids while preserving fertility, as well as to remove the ovarian cyst during pregnancy, while preserving the fetus.

Once again about the advantages of laparoscopy

In addition to all the advantages listed above, laparoscopy makes it possible to carry out two operations at once at a time, while reducing the recovery period for the patient and the risk of wound infection. In addition, the risk of postoperative adhesions is also reduced. And one of the most important advantages of a low-traumatic operation, especially for pregnant women, is that after it the patient practically does not experience pain, that is, she does not need strong painkillers. As you can see, the advantages of face surgery, but it is worth remembering that the condition does not always allow for a laparoscopic operation, and not all clinics currently have the necessary equipment and qualified doctors.

Waiting for a baby is a pleasant and exciting time, even despite the difficulties and malaise inherent in this period. However, concomitant diseases that require surgical intervention may occur.

Immediately, we note that the operation and anesthesia during pregnancy are performed only for urgent and emergency indications, in situations that pose a threat to the life of the mother. If the surgical intervention does not require haste and can be carried out in a planned manner, it is best to wait for the birth of the child, and only then be hospitalized in the hospital for surgical treatment. But in about 2% of women during pregnancy, there is a need for immediate surgery and anesthesia. Most often these are interventions in general surgery and gynecology, dentistry, traumatology.

Surgery for acute appendicitis in pregnant women

The most common reasons for hospitalization of pregnant women in the surgical department are acute appendicitis, acute calculous cholecystitis, pancreatic necrosis, urolithiasis with impaired urine outflow and kidney carbuncle.

Acute appendicitis occurs with a frequency of 1 in 2000 births. It is especially difficult to diagnose and treat it in and out. Diagnostic problems are associated with the fact that an enlarged uterus displaces internal organs from their typical places, especially for such a mobile part of the intestine as the appendix, the inflammation of which is called appendicitis. During the period of gestation, the appendix can move up to the liver and down to the pelvic organs. In addition, nausea, vomiting, and some other symptoms can occur during normal pregnancies.

Often, such expectant mothers enter the hospital quite late, already with a complicated form of appendicitis. At the first stage, ultrasound and diagnostic laparoscopy are used to make sure that surgery is necessary. In some situations, diagnostic laparoscopy turns into a therapeutic one, and if there is no possibility of its implementation, it turns into a laparotomy, an operation with an open access.

In the case of appendicitis, the need for surgery, in principle, is not in doubt, but with acute cholecystitis, pancreatic necrosis and kidney disease, in most cases, it is possible to use symptomatic treatment methods that help avoid surgery or postpone it for the period after childbirth.

Gynecological operations

Currently, gynecological operations during pregnancy are extremely rare. But there are emergencies in which surgical treatment is inevitable. These include rupture or torsion of the ovarian cyst, malnutrition (necrosis) in the myomatous node, suturing of the cervix with isthmic-cervical insufficiency.

Even benign ovarian cysts can potentially be dangerous for a pregnant woman: if the cyst grows to a large size, either rupture or torsion of the ovary can be observed, which leads to bleeding, severe pain and can potentially cause spontaneous miscarriage or premature birth. In this case, an emergency surgery is required. In case of malnutrition in the myomatous nodes, there is an optimal period for their removal - this is more than weeks of pregnancy, when the concentration of progesterone produced by the placenta approximately doubles and under its influence the contractile activity of the uterus decreases, its tone and excitability decrease, the extensibility of muscle structures increases and increases obturator function of the cervix. All this creates the most favorable conditions for the operation. Gynecological operations during pregnancy in most cases are carried out using laparoscopy, and if it is not possible to perform it, a lower midline incision is made, which provides gentle and gentle conditions for the fetus. Surgical correction of the cervix is ​​performed as indicated under epidural anesthesia.

Injuries during pregnancy and other emergencies

Emergency dental care for a pregnant woman is provided at any time of gestation, taking into account the concomitant pathology and allergic status of the patient, under local anesthesia, and does not pose any danger to the woman and the baby's health. But for planned treatment, it is necessary to choose a more optimal time, starting from and more>, after the final formation of the placenta. Dental implantation is strictly contraindicated during pregnancy.

Many women become quite awkward during pregnancy, especially in the last months, and this inevitably increases the likelihood of accidents. They find it difficult to cope with unusual weight and altered posture, and bouts of weakness or dizziness can distract attention at the most inopportune moment. As a result, expectant mothers every now and then get minor bruises, bruises, dislocations and sprains, and in some cases - serious injuries or fractures that require surgical treatment.

Anesthesia during pregnancy

Anesthesia is a constant and inseparable companion of the operation. Therefore, speaking about any negative effects on the mother and fetus, they imply the influence of both the actual surgical intervention and the chosen method of anesthesia. The probability of the presence of congenital anomalies in an infant in a situation where the mother underwent anesthesia and surgery during pregnancy is extremely small and comparable to the incidence of this pathology in pregnant women who have not undergone surgery and anesthesia. With anesthesia during pregnancy, it is not the choice of the drug, that is, the anesthetic that is of great importance, but the technique of the anesthesia itself. In terms of safety for the mother and the fetus, the choice is most often made in favor of local anesthesia. If the operation cannot be performed under local anesthesia, the next choice should be made in favor of regional (epidural) anesthesia. And only in the last place do specialists resort to general anesthesia.

Throughout pregnancy, the baby is reliably protected by a layer of amniotic fluid in the amniotic fluid. This means that all the troubles that happened to a woman in an interesting position, most likely, will not in any way affect the condition and health of the future crumbs. Surgical methods of treatment and their anesthesia for a pregnant woman are difficult and dangerous, but sometimes you cannot do without them. Therefore, if situations arise that require surgical intervention, you should trust the professionals who will certainly help both the mother and her child.

Discussion

thanks for the advice

Comment on the article "Operations during pregnancy: what to do with anesthesia?"

And the duration of the KS operation is insignificant. Usually. When the situation is without complications and anesthesia and surgery are done by professionals. I only had full anesthesia during two laparoscopies - I don’t know for a cesarean do the same or is it stronger?

About anesthesia. Anesthesia for the expectant mother. During any period of pregnancy, anesthesia can damage the developing fetus. try to delay the operation for a period when the risk for the baby is minimal; try to carry out anesthesia and surgery as soon as possible On ...

Discussion

So what happens if my daughter had about 10 anesthesia (only about which I know, excluding resuscitation) + harmonic therapy during my pregnancy, my daughter may not give birth? I just had a shock ... I had 2 anesthesia, now I am preparing for a small operation, there will be anesthesia, and then I am planning a second one, so what?

I had 3 anesthesia. One before pregnancies. 2 after Dimka before Sevka. No problem:). It doesn't affect the brain very well, fact. Memory kicks out :(.

Home> Pregnancy and childbirth> Pregnancy planning> All about pregnancy planning. The peak of fertility in both men and women By the way, and if you have to do an urgent operation during pregnancy - how bad is general anesthesia for a child?

Can I get pregnant immediately after anesthesia? By the way, and if you have to do an urgent operation during pregnancy - how much general anesthesia. After anesthesia, plan your pregnancy in the next cycle. Anesthesia are different. During pregnancy, the anesthesiologist will select ...

Discussion

After laparoscopy, which was done under anesthesia, it is recommended to become pregnant during the first 3 months after the operation. This means that anesthesia is quite acceptable. I'm not worried about this at all.

I think all anesthesia is different ... after all, in the IVF program, the puncture of mature follicles is done under anesthesia

Gentle anesthesia for episiotomy. Medical issues. Pregnancy and childbirth. Gentle anesthesia for episiotomy. Girls, during the first birth I was cut and sutured under general anesthesia ... I am afraid that I will have to go through this a second time ...

Discussion

epidural and do at the very beginning of labor

01/07/2006 21:27:48, zlata

after the first one, two grandmothers-embroiderers-sadists were sewn up in the country-council of deputies .... It's terrible to remember. Local anesthesia, but weak, weak ... horror ...
But then I went through 5 operations in a row for mastitis, from each next anesthesia came out worse and worse ... Not a single day from the last one. I don't want more general anesthesia ... I did 4 abortions under a local ... Song ...
after the second, she did not agree to any general anesthesia (they suggested waiting for the anesthesiologists). no really. Novokainchik - and forward. Normal, no, felt, but normal. It was not difficult to endure (especially after this head of the 39th size)
with the third one there was one inner seam - and did not feel it.
after the fourth, my aunt with golden hands sewed me up. I also asked only locally. It was ok. And sewed it up - perfect. After 5 days, I was already sitting.
so ... perhaps it would be better without tears and cuts ... Well, if they do, it would be better under the local one, so as to be conscious and not catch the waste ...

With an exacerbation of the disease, it is better to postpone the operation. During induction and maintenance of anesthesia, the main goal is to avoid unnecessary ones. Tell me how general anesthesia affects the preparation for pregnancy. I wanted to plan from the next cycle, but ...

Discussion

All this is individually decided by the anesthesiologist.

Sorry if I answered dryly and harshly. Your question turned out like this, in the style of "is it possible to jump from the roof" - from which roof?, For what - having fun ... or saving your child from the flame - sorry if the example turned out to be not very successful.
After all, it all depends on the need and urgency of the operation, on the severity of the underlying disease, on the availability of an experienced team, the necessary medications, etc. - but really, on whether you TRUST the doctors who recommended the operation, the type of anesthesia, and exactly those who will conduct.
It is difficult to advise something other than calmness and prudence.
If you need links and other information - ask.

02/25/2003 22:06:05, MaSanya

Pregnancy and anesthesia. A friend asked to find out. She is pregnant, first trimester. It is necessary to have an operation - to remove the papilloma on the eyelid. Maybe someone did some kind of surgery during pregnancy or knows such cases or where to look something on this topic.

In the last decade, laparoscopy in obstetric practice has become more and more widespread. It is used in the treatment of surgical pathology or for the purpose of diagnosis in difficult cases. According to doctors, about 1-2% of expectant mothers suffer from diseases that require surgical intervention, and often laparoscopy becomes the method of choice for them.

Laparoscopy during pregnancy

The most common pathologies in which such interventions are carried out during childbearing are acute appendicitis, small intestinal obstruction and acute cholecystitis (with stones). Pregnancy is often considered a provoking factor for the formation of such pathologies, but the manifestations in them are quite typical - these are pains in the abdominal region of a growing nature, the appearance of nausea with vomiting. However, it is sometimes difficult to make an accurate diagnosis in case of damage to the digestive tract in the process of bearing a fetus, since often normal nausea can give rise to nausea as a manifestation of toxicosis.

In addition, an accurate and correct diagnosis of pathologists is also difficult because special anatomical changes in the abdominal cavity are formed, which are caused by the growth of the uterus. The scope of diagnostic studies for digestive pathology is very limited, especially in terms of X-ray methods. But, at the same time, as in any acute surgical pathology, such conditions in pregnant women require quick and accurate action in order to reduce the risk of complications and death. If the diagnosis is not made correctly, this is the risk of unnecessary interventions and medication that can potentially harm the fetus. Any manipulation of the uterus or near it carries the threat of premature birth. That is why laparoscopy as a method of diagnosis and treatment of many surgical diseases is preferred today. According to experienced surgeons, if you correctly plan the preoperative period and skillfully perform all the manipulations during laparoscopy, you can safely carry out surgical treatment for expectant mothers with minimal risk of complications and negative effects on the fetus.

Today, data on the impact of laparoscopic operations on the expectant mother and pregnancy, on the fetus are still being studied and systematized. Naturally, this type of operation has significant advantages - the incisions and sutures after laparoscopy are very small, heal quickly and do not require complex care. In addition, the intensity of pain after laparoscopy also decreases, since the surgical access is very small and a very minimal amount of tissues is affected. In addition, the recovery period with such an operation is faster, the operation itself does not last as long and blood loss is minimal. When carrying out an operation for abdominal pain, after laparoscopy, a woman is almost immediately transferred to the ward, without a long stay in intensive care.

Another undoubted advantage will be the fact that the stitches after laparoscopy do not give severe pain, and long-term use of strong analgesics that can affect the fetus will not be required. Despite all these advantages, modern surgeons still do not widely use laparoscopic techniques, fearing possible negative outcomes when creating a pneumoperitoneum (gas in the abdominal cavity).

How does the introduction of gas into the abdominal cavity affect?

One of the significant complications that limits the use of laparoscopy in obstetrics is the creation of a pneumoperitoneum during surgery. Back in the 90s of the last century, experiments were carried out in large and small animals during pregnancy. According to these data, it was shown that carbon dioxide is actively absorbed by the mother's tissues and can enter the placental bloodstream. With prolonged surgery, this can threaten fetal hypoxia. However, further studies showed that the operation in the first or second trimesters did not lead to a shortening of the gestation period and did not increase the frequency of miscarriage, did not affect its weight. However, there are still too few clinical observations of women who have undergone surgery during pregnancy for definite conclusions.

Another difficult task during pregnancy, when surgery is required, is the need for anesthesia. So, in laparoscopic operations, only inhalation general anesthesia with relaxation of the diaphragm and controlled breathing is required. Good postoperative results will largely depend on the length of the induction period and the rapid induction of anesthesia. This is due to the fact that the large size of the uterus and the change in organs gives higher risks of complications, in particular, aspiration of stomach contents.

All funds that are administered to the mother invariably affect the fetus, therefore, strictly dosed administration of drugs in the minimum permissible doses and the shortest possible period of anesthesia is necessary. Despite the fact that general inhalation anesthesia usually relaxes the uterus and does not increase the risk of premature birth, the risk of complications from the respiratory system is several times higher during pregnancy. All these nuances should be kept in mind by anesthesiologists when carrying out anesthesia. In view of all the possible effects of drugs for anesthesia on the fetus, the operation is recommended to be carried out with constant monitoring of the condition of the fetus (the obstetrician listens to the heart with a stethoscope or CTG is performed).

Features of the operation in pregnant women

The ideal time for laparoscopic intervention is the second trimester of pregnancy. At this time, all organs and systems of the fetus have already been formed, and the influence of medications and the pathology itself on them is no longer so critical. In addition, in this period, the size of the uterus is not yet so large, which makes it easier for surgeons to access the abdominal cavity. But, for special emergency indications, laparoscopic operations are performed in any trimester of pregnancy. During the period of introduction into anesthesia, the woman is placed reclining so that the uterus does not crush the inferior vena cava and does not give complications. This is especially important in the third trimester.

The puncture sites during the operation also differ, access near the navel during pregnancy is not applicable, since it is under this zone that the uterus is located, which can be damaged. Pregnant women are operated only by surgeons who have experience in conducting such interventions and only in operating rooms, where there is also an obstetric team.

According to medical statistics, abnormal fetal implantation can occur in any part of the abdominal cavity, but is most often diagnosed in the fallopian tubes. With the development of an ectopic pregnancy and the growth of the embryo, there is a danger of apoplexy of the injured organ.

To prevent severe consequences, methods have been developed to interrupt the full maturation of the ovum outside the uterus. Laparoscopy for ectopic pregnancy is the most common procedure in gynecological practice.

The method is used for accurate diagnosis or minimally invasive surgery. It is carried out to extract the embryo during an ectopic pregnancy.

Previously, laparotomy was used. This is a traumatic surgical procedure, when a tube is removed during an ectopic pregnancy, often together with the ovaries. Today, such operations are performed in the most extreme cases.

Laparoscopy is done for an ectopic pregnancy, during which the surgeon can save the tube if there is no risk to the woman's life.

What types of ectopic pregnancy is laparoscopy performed for?

How is the operation going

WB pathology is classified into several types.

1. Tubal pregnancy - the fertilized cell cannot move to the uterus. Due to obstruction, it is attached to the wall of the pipe, where it begins to develop. It is registered in 97% of patients diagnosed with an ectopic pregnancy.
2. Abdominal - an accidental hit of a wandering zygote in the peritoneal region, where it finds a place for implantation.
3. Ovarian pregnancy - at the exit from the follicle, an active sperm cell comes across on the path of the egg. After fertilization, it is immediately attached to the wall of the nearest ovary. Such an ectopic pregnancy is recorded in a maximum of 0.7% of all cases.
4. Cervical is a very rare anomaly when the ovum matures in the cervix. It is quickly recognized by the woman's sensations or by examination.

Any type of ectopic pregnancy can be diagnosed or operated using a laparoscopic method.

How is laparoscopy done?

If a tubal abortion or rupture of the oviduct is found in an ectopic pregnancy, urgent emergency surgery is required.

Before the manifestation of pronounced signs, a number of preparatory measures are performed to prevent severe complications and shorten the rehabilitation process.

• it is necessary to undergo a detailed examination, pass all the prescribed tests;
• on the day before the operation, it is forbidden to take food and liquids, do an enema to empty the intestines;
• a mandatory item is wearing compression stockings before and after the procedure.

Operation with a laparoscopic method for ectopic pregnancy:

Stages	How do
Patient preparation	Local anesthesia is performed using a ventilator. The working field is treated with an antiseptic solution.
Operation	Three incisions are made - near the navel, on the right and left sides of the iliac zone.
Expanding the space for the surgeon's freedom of action	A certain amount of carbon dioxide is passed through the Veress needle into the peritoneal area.
Introduction of a laparoscope	An optical device with a camera and lighting is introduced through the umbilical opening, additional trocars are introduced through other incisions.
Identifying the cause	Each organ of the small pelvis and peritoneum is carefully examined.
Elimination of pathology	Surgical intervention is performed with the removal or preservation of the tube.
End of operation	After all the manipulations, the formed blood clots are eliminated, the pelvic organs are washed.
Control measures	A re-examination is carried out to exclude defects.
Completion	Instruments are removed from the abdominal cavity, sutures are applied to the incisions, and gas is released from the abdomen. The woman is disconnected from the apparatus and taken out of anesthesia.

Duration of laparoscopy

Laparoscopy of one tube with an ectopic pregnancy has the following advantages:

• the duration of the procedure is 15-60 minutes, depending on the complexity of the clinical case;
• surgery for an ectopic pregnancy does not turn into great stress for the patient;
• blood loss after the procedure is minimal;
• large incisions of the peritoneum are not needed, requiring long-term scarring of the suture, the incisions are so small that later the traces of intervention are almost invisible;
• minimizes the risk of formation of adhesions of the fallopian tubes after ectopic pregnancy;
• the rehabilitation period is shortened;
• the procedure can be carried out for both treatment and prophylactic purposes.

The main advantage is that after laparoscopy with the preservation of the tube with an ectopic pregnancy, a woman has a great chance of conceiving naturally.

When is diagnostic laparoscopy needed?

The endoscopic research method is a common procedure that belongs to the category of minor surgical operations.

The end camera of a laparoscope inserted into the abdominal cavity has the ability to show all movements of the device. The video is broadcast on a color monitor with a 6x magnification of organs and internal processes.

This is what the endocamera of a laparoscope looks like.

Laparoscopic diagnostics are performed during a routine examination or as an emergency measure to understand the clinical condition of the patient.

Indications for endoscopy for ectopic pregnancy:

• clarification of the diagnosis of ectopic conception;
• with strong or unexplained pain in the peritoneal region;
• if necessary, biopsy - cutting off a piece of tissue to detect inflammatory processes;
• if you suspect the formation of cysts, fibroids, tumors in the pelvic area;
• to identify and eliminate adhesions on the fallopian tubes;
• elimination of foci of endometriosis;
• with suspicion of organ apoplexy or the development of an acute condition.

Usually, diagnostic laparoscopy is performed to confirm or establish an accurate diagnosis if an ectopic pregnancy is suspected. Often the examination turns into a therapeutic manipulation.

Pipe saving

The popularity of laparoscopy is explained by the fact that the principle of the technology of the method belongs to the category of organ-preserving operations for ectopic pregnancy.

The indication for intervention is the following factors:

• implantation in the isthmic or ampullar part of the organ;
• an increase in the pipe no more than 4 - 5 cm;
• early ectopic pregnancy up to 4 - 5 weeks.

Varieties of tube-preserving laparoscopy methods.

1. Tubotomy (or salpingotomy) - the embryo is removed by dissecting the tube wall. An operation for an ectopic pregnancy has a high probability of restoring all functions of the organ.
2. Segmental tube resection - removal of the damaged area of ​​the oviduct with the possibility of subsequent plastic surgery.
3. Milking (or extrusion) - is used very rarely when diagnosing trophoblast detachment.

It should be borne in mind that a sparing operation of laparoscopic tubotomy helps to preserve the tube in the early stages of detecting an ectopic pregnancy.

A woman needs to observe all the changes in her body. This will allow you to consult a doctor in a timely manner and quickly identify an ectopic pregnancy.

With pipe removal

This is what the oviduct looks like

With significant changes in the oviduct, it is impossible to carry out organ-preserving surgery. Factors that serve as an indication for laparoscopy with the elimination of the fallopian tube in an ectopic pregnancy.

1. Rupture of the wall of the oviduct when a large area of ​​damage is observed.
2. Hyperemia and cyanosis of the tube during ectopic pregnancy with damage to almost all layers of the membrane.
3. The danger of bleeding during coagulation of the attachment site of the fertilized zygote.
4. Postponed surgery on this tube with a similar diagnosis.

How much does laparoscopy cost?

The cost of a laparoscopy operation in the presence of an ectopic pregnancy depends on:

• the complexity of the clinical situation;
• the volume of manipulations performed;
• the chosen technique of the procedure;
• preservation or removal of tubes and other organs.

The cost is influenced by the level of the medical institution, the class of equipment, the qualifications of the medical staff and the region. For example, in Moscow the prices for laparoscopy for ectopic pregnancy are from 10 to 200 thousand rubles and more. In Yaroslavl, they reach 100 thousand, and in Novosibirsk, up to 50.

Recovery period

Rehabilitation takes from 2 months

In the absence of complications after the laparoscopy operation and the patient's well-being, rehabilitation usually proceeds quickly.

The following signs are considered the norm:

• during the first hours, painful sensations of a weak character are possible;
• an increase in subfebrile body temperature is allowed;
• the appearance of bloody secretions.

How many are in the hospital depends on the patient's condition and the absence of clinical symptoms. The average duration of the postoperative period with an ectopic pregnancy is 10-14 days. A full course of rehabilitation after laparoscopy, including the entire range of rehabilitation measures, lasts no more than a month.

It can be divided into three stages.

1. The first day - until the anesthesia is completely gone, it is recommended to lie down, in the evening more active movements are allowed, drinking is allowed.
2. Hospital treatment - you need to be under constant medical supervision for about a week. The discomfort and soreness may persist for a while due to carbon dioxide residues in the abdominal cavity. The stitches are removed on about the 5th day.
3. Home care - includes physical and antibiotic therapy, diet, compliance with doctor's prescriptions.
   The postoperative period after laparoscopy requires the patient to adhere to the regimen and quality of nutrition, abandon bad habits in order to exclude an ectopic pregnancy at the next conception.

Discharge after laparoscopy

Surgery for ectopic pregnancy requires tracking all your sensations or changes in the body. Internal damage to the genitals can cause vaginal discharge.

To understand whether the inflammatory process develops or not after laparoscopy, you need to pay attention to their nature, abundance and general well-being.

1. Slight, odorless spotting spotting is allowed in the first few days or weeks after surgery. Gradually, they become bloody, and then slimy, resembling leucorrhoea without changing the consistency.
2. Cloudy, yellowish or green discharge accompanied by a foul odor is a sign of infection. You need to see a doctor immediately.
3. Brown discharge without additional symptoms is considered normal. If at the same time the stomach hurts, the temperature rises, an unpleasant odor appears, weakness and fever, then these are signs of the development of the inflammatory process.

In case of dangerous symptoms, the doctor will prescribe a control examination and laboratory tests, according to the results of which appropriate measures will be taken.

Sometimes taking prescribed antibiotics leads to a violation of the vaginal microflora. As a result, white cheesy discharge occurs, which is accompanied by itching and redness of the mucous membranes of the genital organs.

The scars that will remain

This is a sign of the development of candidal colpitis (among the people of thrush). They are treated with vaginal suppositories or antifungal drugs.

Bleeding

Discharge of a bright red color after surgery in an ectopic pregnancy, which come out with clots, while there is no tendency to decrease - this is a sign of a pathological manifestation.

If additional symptoms of increased weakness, tachycardia or dizziness are present, then the condition is interpreted as life-threatening. That is, the situation requires urgent medical intervention.

Despite careful observation, when a laparoscope is inserted in an ectopic pregnancy, there is always a risk of damage to the integrity of the blood vessels, stomach, walls, etc.

In the event of a puncture of any organ, bleeding occurs, to stop which an operation is required to suture the injured area.

Monthly after removal of the pipe

Cycle recovery after 30 days

The onset of the first menstruation after the procedure depends on the physiological characteristics of the body. Cases of prolonged absence or premature profuse bleeding due to tube removal are equally noted.

As a rule, menstruation occurs with a slight delay after tubal laparoscopy due to an ectopic pregnancy. Normal recovery of the cycle occurs within 25-40 days. Often, the reason for the delay is a difficult psychological state of a woman, caused by the stress suffered from the loss of a child.

If the restoration of menstrual function after laparoscopy with an ectopic pregnancy and tube removal does not occur within 2 to 3 months, then the patient is prescribed a course of hormone therapy.

How much sick leave after laparoscopy

The duration of the postoperative period in ectopic pregnancy depends on the clinical picture and the patient's condition. An important fact is how difficult the procedure of laparoscopy was transferred by the woman's body, whether the tube was removed or not.

How many days are kept in the hospital is determined by the doctor. Usually the patient is discharged 5-7 days after surgery for further outpatient treatment.

Checkout in 5-7 days

Sick leave is issued for a maximum of 15 days, for the extension of which you will need to go through a medical commission. When they are released home after laparoscopy, the woman is given recommendations for caring for the sutures, intimacy, personal hygiene, diet, exercise restriction and medication.

What can you eat

During the first days after the operation with an ectopic pregnancy, only drinking non-carbonated mineral water is allowed. Then gradually digestible foods are included in the diet in small portions with a frequency of up to 6 - 7 times a day.

What to eat after laparoscopy of an ectopic pregnancy to reduce the risk of complications:

• lean broth;
• jelly on fruits or berries;
• jelly or compote, weak tea, diluted juice;
• herbal decoctions;
• after three days, cereals (oatmeal, buckwheat, rice) are introduced;
• then include mashed meat or fish products, but only boiled or steamed;
• cottage cheese mixed with low-fat cream;
• bread is replaced with crackers.

The diet after laparoscopy is regulated by the doctor based on the patient's well-being characteristics. In their comments on the forums, women note that a gentle diet allows you to quickly restore the menstrual cycle and organ function.

Fertilization is a miracle

How long can you get pregnant

After a full course of rehabilitation and abstinence from intimacy for a month, the patient is prescribed a repeated diagnostic laparoscopy.

Based on its results, the doctor makes an assessment about the usefulness of the reproductive functions of a woman after an ectopic pregnancy, depending on the preservation or removal of the tubes.

about the author: Fergert Andrey

gynecologist, pediatrician

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The information published on the site is for informational purposes only and is intended for information only. Site visitors should not use them as medical advice! The editors of the site do not advise to self-medicate. The determination of the diagnosis and the choice of the treatment method remains the exclusive prerogative of your attending physician! Remember that only complete diagnostics and therapy under the supervision of a doctor will help to completely get rid of the disease!

While waiting for the baby at any time, a woman may experience complications that require surgical intervention. Several years ago, all operations were performed exclusively in an open way, which posed a threat of premature birth. Today it is possible to carry out surgical intervention for a pregnant woman without negative consequences using laparoscopic technologies.

What is laparoscopy

This is a minimally invasive operation that does not make a complete incision in the abdomen. Laparoscopy is performed using endoscopic (optical) equipment. The introduction of laparoscopic techniques into medical practice has expanded the capabilities of gynecological, urological and general surgical doctors. Laparoscopy during pregnancy is carried out in stages:

1. The woman is injected into endotracheal anesthesia, after which a puncture is made in the abdomen in the navel. This is the first point of the incision, and the places of the rest are calculated after diagnosis (as a rule, these are the left and right iliac region).
2. Gas is injected into the patient's abdominal cavity up to a certain pressure, which increases its volume. This is necessary to create free space for viewing and unhindered manipulation of instruments without the risk of damaging adjacent tissues and organs.
3. Hollow tubes are inserted into the abdominal cavity - tubes intended for the introduction of various endoscopic instruments through them (trocars, endosurgical scissors, a net, a retractor, and others).
4. After that, a panoramic examination of the abdominal cavity is carried out, which makes it possible to identify the presence of tumors, purulent contents, adhesions, the state of the liver and intestines. After the diagnosis, the question of the implementation of surgical treatment is decided.
5. Further, the following tactics are used: surgery, biopsy, drainage of the abdominal strip (excretion of fluid), removal of gas and tubes from the abdomen. After the operation, sutures are applied to three short punctures, which themselves dissolve after 10 days.

Indications for laparoscopy during pregnancy

For a woman, the waiting time for a child is a restructuring of the whole body, therefore a special condition is a provocateur for the formation of various pathologies. When the digestive tract is affected, it can be difficult to make an accurate diagnosis because of the anatomical changes in the abdominal cavity caused by the growth of the uterus. Laparoscopy during pregnancy helps to make the correct diagnosis and eliminate pathology with minimal risk of complications and impact on the fetus. The main indications for the minimally invasive method:

• ectopic pregnancy, if pathology cannot be ruled out in other ways;
• ovarian swelling if it does not go away on its own before 16 weeks of pregnancy;
• torsion of the appendages to prevent tissue necrosis and pelvioperitonitis;
• acute appendicitis, which develops regardless of the gestational age;
• uterine fibroids, when further bearing of the child is impossible without surgery;
• acute cholecystitis, if conservative measures cannot be dispensed with.

Method advantages

Laparoscopy during pregnancy has many advantages over open surgery. Key positives:

• pain syndrome is much less pronounced;
• short duration in comparison with the classical operation;
• fast recovery (from 1 to 3 days);
• high cosmetic effect (from 2 to 5 punctures);
• less traumatic method, since blood loss is minimal;
• low risk of adhesions after surgery;
• anesthesia occurs with the help of endotracheal anesthesia, which prevents the threat of miscarriage.

Complications

Some people think that laparoscopy and pregnancy are two incompatible concepts, because there is a possibility of complications. As with any other operation, the patient is not immune from complications, but a laparoscopic technique is prescribed in the most extreme cases. The complication rate of laparoscopy is low. Main consequences:

• puncture of the uterine wall or injury to the myometrium, when the surgeon chose the wrong place or angle of inclination of trocar insertion;
• rupture of the uterus, if myomatous nodes are removed during pregnancy;
• miscarriage or premature birth can provoke any intervention, including laparoscopy;
• fetal hypoxia may occur if carbon dioxide introduced into the abdominal cavity enters the embryo through the walls;
• allergic reactions from drugs (skin rash, Quincke's edema and others);
• pneumonia, as a complication of endotracheal anesthesia, if the contents of the stomach enter the respiratory tract.

Optimal timing

Laparoscopy is performed at any stage of pregnancy, if necessary. Experts know that the larger the uterus, the more difficult it is to perform surgical procedures, because the space is limited. For this reason, elective operations are scheduled from 16 to 19 weeks of pregnancy. These terms are optimal for surgical intervention. During this period, operations are performed to remove myomas and ovarian cysts. At 16-19 weeks, the uterus is still not very large, and drugs will not affect the already formed structures of the child's internal organs.

Laparoscopy for the diagnosis of ectopic pregnancy

It is difficult for doctors in the early stages to distinguish an ectopic pregnancy, especially with a normally located ovum. If the case is doubtful, then the woman is referred for diagnostic laparoscopy. Upon confirmation of an ectopic pregnancy, it is immediately terminated. The advantages of the method in comparison with others:

• only the ovum is removed with suturing of the fallopian tube (plastic surgery);
• at the same time, other manipulations are carried out: dissection of adhesions, cauterization of foci of endometriosis and others;
• after the operation, the woman has good patency of the fallopian tubes, which increases the likelihood of a successful pregnancy in the future.

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