Pneumoamnion and pregnancy loss after second-trimester laparoscopic surgery

Obstet Gynecol. 2002 Mar;99(3):512-3. doi: 10.1016/s0029-7844(01)01664-7.


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.

Case: 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.

Conclusion: Inadvertent introduction of the Veress needle into the gravid uterus with subsequent pneumoamnion represents a catastrophic complication of midtrimester laparoscopic surgery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Appendectomy*
  • Female
  • Fetal Death / etiology*
  • Fetal Membranes, Premature Rupture / etiology*
  • Humans
  • Laparoscopy*
  • Needles
  • Pregnancy
  • Pregnancy Trimester, Second