Surgical Considerations

  • Clinical Updates in Women's Health Care CU
  • January 2019

ABSTRACT: Obstetrician–gynecologists often incorporate surgical procedures in the care of women. Each phase of a woman’s life cycle presents different challenges regarding preoperative, intraoperative, and postoperative management. Appropriate workup and preparation of patients for surgery are key to a successful surgical outcome. As women age, their risk of medical comorbidities, such as coronary artery disease, diabetes mellitus, or obesity, increases, as does the need for surgical procedures. Correctly identifying medical conditions and related surgical risks will help obstetrician–gynecologists provide safe, appropriate, and evidence-based care to women. Increasingly, obstetrician–gynecologists work in the setting of multidisciplinary teams, and many have access to preoperative assessment clinics and hospitalists to assist in the management of preoperative and perioperative patients. It is the responsibility of the referring physician to understand the services these clinics and hospitalists provide. An appropriate and cost-effective evidence-based preliminary workup, such as laboratory and imaging tests, also is important. The purpose of this monograph is to help guide obstetrician–gynecologists through the appropriate preoperative assessment of women who require surgery and identify intraoperative and postoperative management strategies that will help decrease avoidable morbidity and mortality of these patients.

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