Doctors Lounge - Gynecology Answers
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Forum Name: Obstetrics
|emjoiner - Tue Nov 10, 2009 7:33 pm|
My husband and I are attempting to become pregnant starting this month. He is in the military and if there is any chance of us being able have our first child while he is in training status we would like to so he would be guaranteed to be there during the delivery.
Our problem is that I am due to have oral surgery close to the time I will be ovulating and am worried about any potential harm it could cause. The oral surgeon said that the anesthesia used (Fentanyl+Propofol+Versed+something else I think) could cause major birth defects and he offered to do a pregnancy test before the surgery that day... BUT I would not be technically pregnant yet if I were to conceive.
My surgery is scheduled for Nov. 24th
My estimated ovulation date is Nov. 26th
If I were to become pregnant, the soonest day of implantation would be Dec. 2nd
I guess my question would be, if I were to ovulate early and the anesthesia come in contact with the sperm/egg/zygote, is there any chance of harm or defects? Or does that risk begin after implantation of the fertilized egg when I am actually considered "pregnant"?
I feel like there may not be a risk because the doctor said he could do a pregnancy test before the surgery and if it was negative then it would be ok to continue. But there is the chance of me ovulating during that time and even fertilization of the egg to occur, and I would like to be sure there is no chance of me causing harm.
|Debbie Miller, RN - Tue Dec 01, 2009 12:02 am|
There is always a risk of birth defects in any pregnancy - around 3-5% of all, most of unknown causes. We cannot be 100% sure there will be no damage if you conceive around the time of the surgery but many women have had healthy pregnancies who were exposed to anesthesia without being aware of pregnancy or who just needed it in spite of pregnancy. If you conceive just after the exposure I think your risk would be very low, but I can't say for certain if you were to conceive prior to the anesthesia. The reason they do the pregnancy test first is to try and prevent exposure just in case since we don't do testing of such products on pregnant women. Therefore, much is unknown. Discuss your concerns with your anesthesiologist but most drugs used these days appear to be safe and many surgeries are performed on pregnant women without any clear increased risk.
Of course there is no guarantee you will become pregnant with that particular ovulatory cycle anyway - there is a certain element of luck involved here.
Good luck with your plans.
|Chris Bonney, MD - Sat Mar 20, 2010 4:14 am|
Obviously the woman that asked this question in the first place already had her surgery and hopefully had a successful pregnancy. But I am providing this information for the many others that are in a similar situation and ask for advice.
Before any kind of surgery we perform pregnancy tests on all women within their fertile years to avoid complications with an existing pregnancy.
During the first three weeks of pregnancy the embryo is relative insensitive against toxi influences. During this time toxic influences will cause either the death of the embryo or no malformations at all. We call this the “all or nothing rule”.
Looking at it from a different angle: Many million women each year receive general anesthesia for the implantation of in vitro fertilized eggs and many of them carry out healthy pregancies and have beautiful babies.
Studies of outcomes in large numbers of women who underwent surgery during pregnancy suggest no increase in congenital abnormalities but a greater risk of abortion, growth restriction and low birth weight. These studies concluded that problems resulted from primary disease of the mother or the surgical procedure itself rather than exposure to anaesthesia (Mazze RI and Kallen B. Reproductive outcome after anaesthesia and operation during pregnancy: a registry study of 5405 cases. Am J Obstet Gynecol 1989).
My advice: If you are pregnant - avoid all kinds of planned surgery and have them no earlier than 6-8 weeks after birth of the baby. If you have to have emergency surgery during pregnancy chances are very high that nothing will go wrong with the foetus.
I hope this helps.
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