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Pneumoamnion and Pregnancy Loss After Second-Trimester Laparoscopic Surgery

Department of Obstetrics and Gynecology, Mayo Medical Center, Rochester, Minnesota

Address reprint requests to: Jennifer D. Friedman, MD, Department of Obstetrics/Gynecology, Mayo Medical Center, Eisenberg 4A, 200 1st Street, SW, Rochester, MN 55905; E-mail: friedman.jennifer{at}mayo.edu.

ABSTRACT

BACKGROUND: Midtrimester laparoscopic surgery is considered safe; however, both maternal and fetal complications can occur. We report a case of midtrimester pregnancy loss with pneumoamnion after laparoscopic appendectomy.

CASE: A young woman presented at 21 weeks’ gestation with a 3-day history of nausea and severe abdominal pain. Diagnostic laparoscopy was performed with normal appendix and pelvic anatomy noted. Worsening pain prompted a repeat laparoscopic evaluation. A small defect in the uterine serosa was noted, which presumably resulted from inadvertent Veress needle injury. Abdominal computerized tomography was performed, which demonstrated a pneumoamnion. Spontaneous rupture of membranes and labor ensued, resulting in the delivery of a stillborn fetus.

CONCLUSION: Inadvertent introduction of the Veress needle into the gravid uterus with subsequent pneumoamnion represents a catastrophic complication of midtrimester laparoscopic surgery.

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				P. A. Pastore, D. M. Loomis, and J. Sauret Appendicitis in Pregnancy J Am Board Fam Med, November 1, 2006; 19(6): 621 - 626. [Abstract] [Full Text] [PDF]