35 weeks and needing hand surgery ASAP!

This pregnancy has been great so far, but a huge monkey wrench just got thrown into the mix!

I avulsed (ruptured) the flexor tendon of my left ring finger on Monday 9/8, which means that I cannot bend at the last joint of that finger. The only treatment is surgery, and it needs to happen ASAP after injury to give the best chance of regaining full use of my hand. Surgery has been scheduled for next Wednesday 9/17, and they wanted to have me under general anesthesia but I said I would only have a local during pregnancy.

I haven't started dilating yet, and my cervix is still high but is softening. I've only had one "real " contraction so far, about 10 days ago. The babies are doing great, NSTs have been fine, I'm also fine.

Has anyone else had to undergo surgery while pregnant? If so, was it under local or general anesthesia? Were there any complications with the pregnancy? My OB said she is comfortable with me under general, but I just feel like I should be awake if possible.

Thanks for any advice you may have, or stories to tell.
Susan

 

So sorry you injured yourself and will have to have surgery!

I had a kidney stone at 24 weeks that was too large to pass on its own (it was stuck up in the ureter) and too high to reach to remove, so I had to have stent placed from my kidney to bladder. The procedure was done under general anesthesia. I was advised that the only risk in terms of being under general anesthesia were a very slight risk of causing (premature) labor. I ended up with no labor or other complications with the babies. (I had to have the dang stent in the rest of the pregnancy and until the babies were 6 weeks old, and it was really painful...but that's another story!).

Good luck!

 

I'm a hand surgeon and your doctor is correct about needing to do the surgery quickly in order to restore finger flexion. It is generally considered safe to undergo general anesthesia in your third trimester. They will check fetal heart tones before and after surgery and as long as the heart rates are stable and you don't begin contracting, you would be able to go home after surgery. Local generally doesn't work as well for this type of surgery. Sometimes the tendon can retract into the proximal finger or palm (into areas which may not be as numb). Also, a tourniquet is needed to prevent blood flow to your arm so that your surgeon can adequately visualize the structures. This is inflated on your upper arm and will get very uncomfortable before the surgery is over. Another option is a Bier block - a tourniquet is placed on your upper arm and an IV is started in your hand. The tourniquet is inflated and a numbing medicine is injected through the IV. The tourniquet keeps the medicine from circulating through your body, so that only your arm is numb, but you can remain awake or slightly sedated. This makes the tourniquet somewhat more comfortable.

You'll have to work closely with a therapist post-op and will not be allowed to actively flex your finger for several weeks. May make diaper changes a little more of a challenge!

By the way, with my last pregnancy, I had to have a lap cholecystectomy at 31 weeks. It was done under general anesthesia and I had no complications. I had to stay overnight due to contractions, but they were able to finally stop them and I went on to carry my daughter to full term before delivery.

Good luck!

 

Thank you very much for your responses! The surgeon did say that general anesthesia is preferred, but was willing to do local due to my concerns. He warned me about the tourniquet discomfort. I may now change my mind and go with general, now that I've had feedback from you both as well as my OB, so thank you very much for helping me!

Susan

 

I was much earlier in my pregnancy, but I had general anesthesia at 16 weeks (had to have my gallbladder out) and it was fine. They gave me Indocin to help prevent against contractions and pre-term labor (doesn't sound like that is really an issue with you) and the only thing different was they didn't give me any Versed. So, when most people have surgery, they don't really remember going into the OR because the Versed is already on board; I remember going into the OR, getting put to sleep, and that's it. The OB checked the heart tones before and after surgery. All was well.

Good luck.