Acute abdomen during pregnancy has a complex etiology and rapid changes, and is often difficult to diagnose and treat appropriately in a timely manner. About 0175%-2% of pregnant women require surgery for non-obstetric abdominal disorders such as cholecystitis, appendicitis, and adnexal tumors. With the popularity of laparoscopy and the increasing maturity of the technology, pregnancy is no longer a contraindication to abdominal surgery. In laparoscopic surgery, because the uterus is not exposed to air during the operation, there is no direct pressure on the uterus, and the pelvic cavity is less disturbed, thus reducing the stimulation to the fetus. The pregnant woman can quickly return to the physiological state of pregnancy after surgery. However, hypercapnia and abdominal pressure may cause uncertain effects on the fetus, such as miscarriage, preterm delivery or stillbirth, so to a certain extent the development of laparoscopic surgery during pregnancy is limited. In recent years, with further research on the effects of laparoscopy on the mother and fetus, it has been gradually recognized that laparoscopic surgery is a surgical procedure with early and clear diagnosis, less damage and faster recovery. The maternal effects of CO2 pneumoperitoneum are minimal when the abdominal pressure is maintained between 10 and 12 mmHg (1 mmHg = 01133 kPa), the duration of surgery is controlled, and effective ventilation is maintained, and the risk of preterm delivery, fetal growth restriction, congenital malformations, and low intelligence is not increased. It has been suggested that the elevated CO2 is due to exogenous CO2 uptake and not due to increased metabolism in the body, therefore, this hypercapnia is often not accompanied by hypoxemia, but the effect of hypercapnia on the fetus has not been observed in the long term, and the effect on fetal behavior and development needs further study. Although laparoscopic surgery during pregnancy is not contraindicated, it must be performed within the limits of ability and in a way that is convenient and easy to perform without affecting the pregnancy and the fetus; skilled laparoscopic technique and experience are prerequisites for successful surgery; and comprehensive and detailed preoperative interview, understanding and cooperation of the pregnant woman and her family are important for the implementation of surgery. Intraoperative minimization of unnecessary stimulation is the key to reduce the rate of postoperative miscarriage. Acute appendicitis is a common surgical disorder during pregnancy, which is difficult to diagnose and relatively serious, and occurs mostly before the sixth month of pregnancy. Due to the delay in diagnosis and treatment, the incidence of appendicitis in pregnancy and the death rate increase, so once the suspicion of appendicitis should be performed immediately exploratory surgery. The enlarged uterus can change the position of the appendix, making conventional open surgery more difficult. Laparoscopic appendectomy during pregnancy has been controversial in the past. However, recent studies have shown that laparoscopic appendectomy is feasible in women with early and midterm pregnancies. Palanivelu et al. reviewed patients who underwent laparoscopic appendectomy for acute appendicitis and appendiceal perforation during pregnancy over a 10-year period, with no postoperative complications and satisfactory pregnancy outcomes, and concluded that laparoscopic treatment of appendicitis during pregnancy is effective and safe for both mother and fetus. Carver et al. compared patients who underwent appendectomy in early pregnancy under open surgery versus laparoscopic surgery for surgical and pregnancy complications, length of hospital stay, pregnancy outcome, and neonatal birth weight. There were no significant differences in surgical and pregnancy complications, length of hospital stay, and birth weight of the newborns, but there were two cases of fetal death after laparoscopic surgery, which should be noted although the differences were not statistically significant. The sample should continue to be expanded for further study. Compared with traditional surgery, laparoscopic appendectomy has the following advantages: (1) small incision, less damage to the body, less postoperative wound pain, rapid recovery of gastrointestinal function, and early postoperative bed activity. (2) Due to the enlargement of the uterus, the position of the appendix is often higher than the normal position, making it easier to find the appendix. (3) The chance of postoperative intestinal adhesions is less. These are conducive to the postoperative recovery of the pregnant woman and the health of the fetus. The study concluded that ultrasound and CT examination are necessary for the altered physiological status during pregnancy. If the position of the appendix is not abnormal and the appendix is simple or septic appendicitis, the position of the appendix should be determined preoperatively by ultrasound or CT. Laparoscopic appendectomy should not be performed if the appendix is in an abnormal position (e.g., retroperitoneal appendix) or if the appendix is obscured by an enlarged uterus, making exposure difficult. Laparoscopic appendectomy should not be performed if the appendix is perforated and complicated by diffuse peritonitis, severe pelvic infection, or if the uterus or placenta is infected and requires cesarean delivery, or if the fetus is in distress, as CO2 absorption during pneumoperitoneum can aggravate intrauterine hypoxia of the fetus. In late pregnancy, laparoscopic appendectomy should not be chosen because of the small operating space. 2, pregnancy combined with cholecystitis in pregnancy, cholecystitis is the incidence of surgical diseases second only to appendicitis. It can cause preterm delivery, miscarriage and even maternal death. Non-surgical treatment prolongs the treatment time and leads to repeated hospital admissions, while surgical treatment poses certain risks to the pregnant woman and the fetus, so cholecystitis in pregnancy should be treated on a case-by-case basis and appropriate treatment should be chosen. For uncomplicated cholecystitis, conservative treatment is often used, while for more serious cases such as recurrent cholecystitis, acute cholecystitis, obstructive yellow, gallstone pancreatitis and peritonitis, surgical treatment should be performed. Numerous reports have shown that laparoscopic surgery for cholecystitis is safe and feasible. The surgery should be performed in the middle of pregnancy. During surgery, the head is placed in a low-hip-high supine position, with the degree of tilt appropriate to minimize compression of the vena cava by the pregnant uterus. It has also been suggested that a low left and high right position is possible to separate the uterus from the vena cava. If the uterus is not too large, the trocar can be placed in the same position as in non-pregnancy, with the first trocar placed in the right upper abdomen lateral to the midclavicular line in late pregnancy. Halkic et al. retrospectively analyzed patients who underwent laparoscopic surgery for cholecystitis between 1990 and 2005 and concluded that laparoscopic cholecystectomy during pregnancy is safe for both mother and fetus. Laparoscopic surgery is feasible in the treatment of cholecystitis in pregnancy. 3, pregnancy combined with benign ovarian tumor ovarian tumor in pregnancy is often asymptomatic and makes diagnosis difficult. Ultrasonography is a safe, effective and intuitive diagnostic aid, which can not only accurately understand the size, shape and internal echo of ovarian masses, but also provide clues to differentiate benign or malignant to a certain extent. Some scholars believe that if ovarian cysts < 5 cm in diameter are found in early pregnancy, they can be followed up regularly. However, some scholars believe that once diagnosed, ovarian tumors in pregnancy should be operated promptly without concern for the month of pregnancy to avoid complications or even malignant changes that may delay treatment. For patients with confirmed benign tumors, surgery should be performed by resection as much as possible to preserve as much ovarian tissue as possible. The treatment of benign ovarian tumors in pregnancy is the same as that in non-pregnancy. Surgery includes excision of the mass (oophorectomy), removal of the ovary (oophorectomy) and tubo-ovariectomy, both open and laparoscopic surgery. However, laparoscopic surgery has the advantages of shorter hospital stay, early activity and less postoperative pain compared with open surgery. The main problem of laparoscopic surgery for benign ovarian tumors combined with pregnancy is how to minimize the irritation to the pregnant uterus and shorten the operation time. Therefore, the appropriate treatment should be chosen according to the type and location of the lesion, in order to minimize complications and not to interfere with the continuation of the pregnancy after surgery. Therefore, the timing of the operation should be as early as possible between the 4th and 6th month of pregnancy. Whether it is an intrauterine pregnancy with gynecological emergencies or an asymptomatic adnexal mass, laparoscopic surgery in early pregnancy not only allows for early diagnosis and timely treatment, but also allows for a smaller uterus in early pregnancy, a larger operative field of view, and less chance of pulling or touching the uterus. The abdominal pressure may cause nausea, vomiting, postoperative shoulder pain and visceral pain, as well as altered uteroplacental hemodynamics. However, these two effects can be minimized intraoperatively by reducing the rated pressure of the artificial pneumoperitoneum, decreasing the inflation rate, shortening the operative time, continuous intraoperative mask oxygen administration and postoperative CO2 evacuation. A META study conducted by Bunyavejchevin et al. showed that there was insufficient evidence that laparoscopic surgery has a greater impact on the fetus than open surgery. It is now believed that laparoscopic surgery has some advantages over open surgery. In cases of ovarian cyst torsion during pregnancy, surgery should be performed as soon as it is detected. With the development of laparoscopic techniques, there have been numerous studies reporting that laparoscopic surgery is safe for both mother and fetus. The treatment of laparoscopic torsion of ovarian cysts was reviewed by Rackow et al. who concluded that laparoscopic surgery is safe and feasible. The current study concluded that laparoscopic surgery should be performed within 14 weeks of gestation if laparoscopic surgery is chosen in cases of ovarian cyst torsion in pregnancy. For those who are more than 14 weeks of gestation or whose masses are deep in the rectal recesses of the uterus, laparoscopic surgery should be chosen with caution because of the inconvenience of removing the masses from the pelvis. The operation should be performed on a cystic mass or a well-moving mass with a diameter of 7-8 cm or less, although it is possible to have a slightly larger mass if the gestational week is small. During the operation, the oxygen saturation should be monitored dynamically and maintained, and the abdominal CO2 pressure should be kept at 8-10 mmHg. During the operation, direct contact of instruments with the uterus should be minimized or avoided, and the electrocoagulation power should be low, and monopolar electrocoagulation should be minimized or avoided. It is best to remove the specimen in a specimen bag to reduce or avoid abdominal fluid leakage. Avoid flushing the pelvic and abdominal cavities with large amounts of cold saline to reduce stimulation of the uterus. Pay attention to intraoperative fluid replacement and changes in vital signs, and perform postoperative blood gas monitoring to correct disturbances in acid-base balance in a timely manner. Low-flow oxygenation may be given. Current studies suggest that laparoscopy is feasible and safe in cases of ovarian cyst torsion during pregnancy. Kosaka et al. reported a case of a 26-year-old pregnant woman with progressive hypertension and hypokalemia at 14 weeks of gestation and markedly elevated plasma aldosterone levels, which was diagnosed as primary aldosteronism due to adrenal adenoma on magnetic resonance. Due to severe progressive hypertension, laparoscopic adrenal tumor resection was performed at 17 weeks of gestation. Postoperatively, there were no complications and the blood aldosterone and potassium levels improved significantly. However, hypertension persisted and intrauterine fetal growth retardation was observed. Fetal death occurred at 26 weeks of gestation. Blanco et al. reported a case of a 30-year-old woman with signs and symptoms of moderate cortisolism, diagnosed as ACTH-dependent Cushing's syndrome. Urinary cortisol excretion was increased and cortisol secretion was out of rhythm; ACTH levels were low and plasma aldosterone secretion was not inhibited by dexamethasone. A CT scan of the abdomen confirmed a left adrenal mass. At this time, the patient was pregnant and requested to keep the fetus. At 8 weeks of gestation, the cortisol increase was controlled with medication, and at 16 weeks, a laparoscopic resection of the left adrenal mass was performed. The pathological diagnosis was benign adrenal tumor. The patient had secondary adrenal insufficiency and was treated with hydrocortisone 20 mg daily for symptomatic control. There was no obvious drug teratogenicity and no clinical or biochemical changes of adrenal insufficiency. Therefore, it is believed that for Cushing's syndrome in pregnancy, once diagnosed, it should be treated immediately with medication, and laparoscopic treatment in the middle of pregnancy can effectively prevent the complications of cortisolism, and it is safe for both mother and fetus. 5, amniotic cord syndrome amniotic cord syndrome can be caused by amniotic cord indentation, limb mutilation, complex craniofacial, visceral and body wall defects. The incidence is 1/1,200 to 1/15,000, and most fetuses die from complex congenital malformations. A small percentage of surviving infants often have severe limb deformities. It has been reported that laparoscopic release of the spastic stenotic ring of the uterus may prevent severe fetal limb deformities and improve fetal survival. In conclusion, with the popularity of laparoscopy and the increasing maturity of the technology, pregnancy is no longer a contraindication to abdominal surgery. The long-term effects of laparoscopy on the fetus have yet to be further investigated. The development of laparoscopic surgery in pregnancy has posed a greater challenge to the majority of clinical laparoscopists and has opened up new horizons in the diagnosis and management of pregnancy-related diseases.