Niet-obstetrische perioperatieve zorg bij zwangeren

The recently published Dutch guideline ‘Non-obstetric perioperative care during pregnancy‘ provides recommendations for managing surgical procedures in pregnant patients. Despite limited evidence, key recommendations include favouring minimally invasive techniques, such as laparoscopy, due to reduced recovery time and complications. Laparoscopy is feasible in all trimesters, with considerations for uterine size and trocar placement. Neuraxial or regional anaesthesia is preferred over general anaesthesia when possible, as it improves postoperative pain control and reduces opioid use. Routine foetal monitoring is not recommended unless significant maternal hemodynamic fluctuations are expected. The timing of surgery should be carefully evaluated, with elective procedures preferably postponed unless medically necessary. A multidisciplinary approach involving surgeons, obstetricians, anaesthesiologists, and neonatologists is essential for optimizing maternal and foetal outcomes. Shared decision-making and thorough patient counselling remain crucial.

Conflict of interest and financial support: none declared.