Is pregnancy a contraindication to joining an operation in the (operating room)?

Pregnancy is NOT an Absolute Contraindication to Working in the Operating Theatre

Pregnant healthcare workers can safely participate in operating theatre activities with appropriate precautions and modifications, though specific occupational hazards must be carefully managed to protect both maternal and fetal health. 1

Key Considerations for Pregnant Operating Theatre Staff

Radiation Exposure

• Pregnant staff can safely participate in procedures involving radiation if proper precautions are followed 1
• Participation in fewer than 100 sentinel node biopsy operations during gestation will remain below recommended radiation limits for pregnant women 1
• Mean whole-body dose received by surgical staff is <1μSv per operation, with maximum surgeon dose <2μSv 1
• Lead shielding and proper contamination control minimize occupational radiation exposure to acceptable levels 2
• For fluoroscopy procedures above the diaphragm (head, chest), fetal exposure from scattered radiation is minimal and typically well below harmful thresholds 1

MRI Environment Hazards

• The MHRA advises that pregnant staff should NOT remain in the MRI scan room while imaging is underway 1
• Primary concern is acoustic noise exposure to the fetus 1
• In interventional situations where staff work near the scanner aperture during scanning, time-varying gradient and RF fields may also pose concerns 1
• If pregnant staff must remain present (e.g., supporting a pediatric patient's mother), benefits and risks must be thoroughly discussed beforehand 1

Anesthetic Gas Exposure

• Proper ventilation systems and scavenging equipment in modern operating theatres have significantly reduced anesthetic gas exposure risks 2, 3
• Guidelines on safe exposure levels and use of personal protective equipment help minimize risks to pregnant staff 2
• Historical concerns from the 1960s about anesthetic gases have been largely mitigated by current safety standards 2

Chemical Exposures

• Methylmethacrylate (bone cement) exposure requires proper personal protective equipment 2, 4
• Surgical smoke exposure should be minimized with appropriate evacuation systems 4
• Formaldehyde and surgical scrub solutions have evidence of negative pregnancy outcomes and require protective measures 4

Physical Demands and Work Hours

• Prolonged strenuous activity and excessive work hours are associated with increased pregnancy complications 2, 5
• Residents with more than 6 nights on call per month had significantly higher obstetrical complication rates (49.3%) compared to those with ≤6 nights (26.4%) 5
• Surgical residents performing >8 hours of operating room time per week had complication rates of 41.7% versus 8.9% for those with ≤8 hours 5
• Short periods of moderate physical activity are beneficial, but prolonged standing and strenuous surgical activity should be limited 2

Blood-Borne Pathogen Risk

• Risk of contamination with blood-borne pathogens is low when proper personal protective equipment is used 2
• Effective post-exposure prophylactic regimens are available for hepatitis B and HIV 2
• Mandatory use of proper PPE makes this risk manageable 2

Practical Recommendations for Pregnant Theatre Staff

Work Modifications

• Avoid remaining in MRI scan rooms during active imaging 1
• Limit operating room time to ≤8 hours per week if performing surgery 5
• Restrict call schedule to ≤6 nights per month 5
• Use proper lead shielding for all radiation-based procedures 1, 2
• Ensure adequate ventilation and scavenging systems are functioning 2

Monitoring and Support

• Pregnant staff should have individualized work plans developed with occupational health services 4
• Regular assessment of physical demands and exposure levels is warranted 4
• Pregnant residents and staff have higher rates of miscarriage, hypertension, placental abruption, and intrauterine growth restriction compared to the general population 5

Common Pitfalls to Avoid

• Do not assume all operating theatre work is contraindicated in pregnancy - with proper precautions, most activities are safe 1, 2
• Do not ignore cumulative radiation exposure - track total exposure across all procedures 1
• Do not underestimate the impact of prolonged work hours and physical demands - these have the strongest evidence for adverse pregnancy outcomes 5
• Do not neglect proper PPE use - this is the primary protection against chemical and infectious hazards 2