Monday, November 24, 2014
MAC during pregnancy
I recently had a surgery in which they used MAC (monitored anesthesia care, I believe?). I found out two days later that I am in the very beginning stages of pregnancy. This procedure was done before my first missed period. What are the risks to the fetus or chances of spontaneous abortion with this type of anesthesia?
Any risk of abortion (miscarriage) or of harm to your developing fetus is much more likely to be related to the condition which prompted the surgery, and to the surgical procedure itself. Conditions that are associated with fever, or that affect the pelvic organs, may lead to miscarriage. There is not a lot of data from scientific studies about the effects of anesthetic agents in early pregnancy in humans (how would you get anyone to sign up?!). So the information we do have comes from anecdotal reports, and from animal studies (which often don't translate to humans). The good thing is, even this scanty and indirect evidence suggests that standard anesthetic agents have few if any effects on the developing fetus, assuming the condition of the mother during the anesthetic and surgery is satisfactory. In other words, the mother's oxygen levels, blood pressure and heart output, temperature and other metabolic functions are in the normal range.
This doesn't mean that an anesthetic during pregnancy is a good thing, or something to be undertaken lightly, but it does suggest that the risk is low. In fact most centers have policies or practices intended to avoid your scenario. It is our practice to inquire of any female of child-bearing potential about the possibility of pregnancy. Where there is even the slightest possibility, a pregnancy test is done, with the patient's consent. In some centers, pregnancy testing is routine in all cases.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University