title: Fetal monitoring during nonobstetric surgery: revisiting guidelines: a case report.
abstract: BACKGROUND
  Nonobstetric surgery during pregnancy is not an infrequent occurrence. Guidelines for fetal monitoring during nonobstetric surgery are limited. We describe a case of appendectomy during third trimester, complicated by in utero fetal demise (IUFD).
  
  
  METHODS
  A 30-year-old, Caucasian woman underwent open appendectomy for suspected acute appendicitis. The procedure was complicated by IUFD. Fetal monitoring was done prior to but not during surgery. Guidelines for fetal monitoring were revised, recommending continuous electronic fetal monitoring when possible during third trimester nonobstetric surgery after appropriate patient counseling. A subsequent series of 5 uncomplicated appendectomies demonstrated no difficulty in implementing these guidelines.
  
  
  CONCLUSIONS
  Continuous electronic fetal monitoring during third trimester nonobstetric surgery should be available and implemented after appropriate patient counseling. This approach reduces the risk of fetal mortality.
authors.forename: Tod J
authors.initials: TJ
authors.lastname: Rothschild
authors.forename: Bruce
authors.initials: B
authors.lastname: Morel
authors.forename: Benjamin
authors.initials: B
authors.lastname: Pace
authors.forename: Aleksandr M
authors.initials: AM
authors.lastname: Fuks
mesh_terms: D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000601:surgery; D005260:Female; D005313:Fetal Death; D005323:Fetal Monitoring; D006801:Humans; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000601:surgery*; D011263:Pregnancy Trimester, Third; D011300:Preoperative Care