Pneumoamnion and pregnancy loss after second-trimester laparoscopic surgery.
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.


METHODS
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.


CONCLUSIONS
Inadvertent introduction of the Veress needle into the gravid uterus with subsequent pneumoamnion represents a catastrophic complication of midtrimester laparoscopic surgery.
Friedman
Jennifer D
JD
Department of Obstetrics and Gynecology, Mayo Medical Center, Rochester, Minnesota 55905, USA. friedman.jennifer@mayo.edu
Ramsey
Patrick S
PS
Ramin
Kirk D
KD
Berry
Colin
C
D000328:Adult; D001062:Appendectomy; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology*; D006801:Humans; D010535:Laparoscopy; D009339:Needles; D011247:Pregnancy; D011262:Pregnancy Trimester, Second