Nonobstetric surgery during pregnancy in Finland during a 21‐year period: A register‐based study

Abstract

Abstract Objective To assess how much and on which specialities nonobstetric surgery was performed for pregnant women in Finland during a 21‐year period, between 1997 and 2017 and the effect of Finnish guideline about preoperative evaluation affected the amount of surgery during pregnancy. Design Register‐based observational study. Setting Finnish Medical Birth Register. Population 1 175 677 pregnancies ending with a singleton birth 1997−2017. Methods Amount of nonobstetric surgeries, and pregnancy foetal and maternal outcomes in Finland between 1997 and 2017 were searched. Main Outcome Measures The prevalence of nonobstetric surgery, and proportions of elective and emergency nonobstetric surgery performed during the three trimesters. Results The prevalence of nonobstetric surgery before the guideline was 0.39%, after the guideline 0.28% and after the first revision 0.39%. The prevalence of elective surgery decreased after the guideline (before 0.15%, after the guideline 0.10% and 0.07% after the first revision), but the prevalence of emergency surgery was highest after the first revision (0.24%, 0.21% and 0.29%). The guideline and the first revision had no impact on the timing of elective surgery; 35% of elective surgery was performed during the second trimester before the guideline, 36% after it and 36% after its first revision. The preterm delivery rate, 9.1%−9.4% of pregnancies with nonobstetric surgery was twofold higher than that of pregnancies without surgery. Conclusion The prevalence of nonobstetric surgery during pregnancy is low in Finland. The national guideline decreases the prevalence of elective surgery during pregnancy but does not impact the timing of nonobstetric surgery.

Keywords

• nonobstetric
• outcome
• pregnancy
• prevalence
• register study
• surgical procedures