Recommendations for Management of Parturients and Surgical Procedures Recommendations for Management of Parturients and Surgical Procedures

Flowchart

Pregnant Surgical
Patient Elective
Surgery Elective Surgery Essential
Surgery Essential Surgery Emergency
Surgery Emergency Surgery Pregnant Surgical
Patient
Elective
Surgery Elective Surgery Elective
Surgery
Elective Surgery Essential
Surgery Essential Surgery Essential
Surgery
Essential Surgery Emergency
Surgery Emergency Surgery Emergency
Surgery
Emergency Surgery Essential
Surgery Essential
Surgery
First Trimester First Trimester Second/Third
Trimester Second/Third Trimester First Trimester First Trimester First Trimester First Trimester Second/Third
Trimester Second/Third Trimester Second/Third
Trimester
Second/Third Trimester First Trimester First Trimester If Greater than Minimal
Increased Risk to Mother,
Proceed with Surgery If Greater than Minimal Increased Risk to Mother, Proceed with Surgery If no or Minimal Increased
Risk to Mother, Consider
Delaying Until Midgestation If no or Minimal Increased Risk to Mother, Consider Delaying Until Midgestation If Greater than Minimal
Increased Risk to Mother,
Proceed with Surgery If Greater than Minimal Increased Risk to Mother, Proceed with Surgery If Greater than Minimal
Increased Risk to Mother,
Proceed with Surgery

If Greater than Minimal Increased Risk to Mother, Proceed with Surgery If no or Minimal Increased
Risk to Mother, Consider
Delaying Until Midgestation If no or Minimal Increased Risk to Mother, Consider Delaying Until Midgestation If no or Minimal Increased
Risk to Mother, Consider
Delaying Until Midgestation

If no or Minimal Increased Risk to Mother, Consider Delaying Until Midgestation If Greater than Minimal
Increased Risk to Mother,
Proceed with Surgery If Greater than Minimal
Increased Risk to Mother,
Proceed with Surgery

Proceed with Optimal Anesthetic for
Mother, Modified by Considerations for
Maternal Physiologic Changes and Fetal
Wellbeing.
Consult a Perinatologist or an
Obstetrician.
Intraoperative and Postoperative Fetal
and Uterine Monitoring may be Useful. Proceed with Optimal Anesthetic for
Mother, Modified by Considerations for
Maternal Physiologic Changes and Fetal
Wellbeing.
Consult a Perinatologist or an
Obstetrician.
Intraoperative and Postoperative Fetal
and Uterine Monitoring may be Useful.






If no or Minimal Increased
Risk to Mother, Consider
Delaying Until Midgestation If no or Minimal Increased
Risk to Mother, Consider
Delaying Until Midgestation

Second/Third
Trimester Second/Third
Trimester
Emergency
Surgery Emergency
Surgery
Second/Third
Trimester Second/Third Trimester Proceed with Optimal Anesthetic for
Mother, Modified by Considerations for
Maternal Physiologic Changes and Fetal
Wellbeing.
Consult a Perinatologist or an
Obstetrician.
Intraoperative and Postoperative Fetal
and Uterine Monitoring may be Useful. Proceed with Optimal Anesthetic for Mother Second/Third
Trimester Second/Third Trimester Second/Third
Trimester
Second/Third Trimester Proceed with Optimal Anesthetic for
Mother, Modified by Considerations for
Maternal Physiologic Changes and Fetal
Wellbeing.
Consult a Perinatologist or an
Obstetrician.
Intraoperative and Postoperative Fetal
and Uterine Monitoring may be Useful. Proceed with Optimal Anesthetic for Mother Proceed with Optimal Anesthetic for
Mother, Modified by Considerations for
Maternal Physiologic Changes and Fetal
Wellbeing.
Consult a Perinatologist or an
Obstetrician.
Intraoperative and Postoperative Fetal
and Uterine Monitoring may be Useful.






Proceed with Optimal Anesthetic for Mother Elective
Surgery Elective
Surgery
Delay Until
Postpartum Delay Until
Postpartum