Obstetric outcomes following non-obstetric abdominal surgeries during pregnancy in a multicenter retrospective cohort study from the United Arab Emirates

Non-obstetric surgeries are rare but may be associated with significant maternal and fetal risks to pregnancy. In this multicenter retrospective descriptive cohort study, we evaluated the maternal, obstetric, and neonatal outcomes associated with non-obstetric abdominal surgery during pregnancy as well as safety and feasibility of different surgical approaches. We analyzed data from 78 pregnant patients who underwent non-obstetric abdominal surgeries at three leading tertiary center hospitals in the Emirate of Abu Dhabi (United Arab Emirates) between January 1, 2008, and December 31, 2023. Most women in our cohort underwent surgery in the first (46.2%) or second (43.6%) trimester. The most common initial diagnoses were ovarian cysts (37.2%), ovarian torsion (32.0%), and appendicitis (30.8%). Most surgeries were performed laparoscopically (86.0%), and 77 patients (98.7%) had no intraoperative complications. A positive correlation was observed between gestational age at diagnosis and interval from diagnosis to surgery (ρ = 0.301, p = 0.029), as well as the length of hospital stay (ρ = 0.316, p = 0.005). There was a positive correlation between gestational age at surgery and postoperative complications (χ²=7.016, p = 0.030). Our findings suggest that non-obstetric emergency surgeries can be performed during pregnancy, with relatively low complication risks when rapid diagnostics are implemented. The results should, however, be taken with caution as substantial proportion of key fetal outcome data are missing. Because the laparotomy group was small, the present study was not powered to compare surgical approaches definitively. Therefore, although our findings support the feasibility and safety of laparoscopic surgery during pregnancy, the choice of surgical approach should remain individualized according to the patient’s clinical condition, the underlying pathology, surgeon expertise, and current clinical guidelines.