{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T10:13:50Z","timestamp":1777976030569,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess and compare the ergonomic challenges faced by microvascular surgeons at 36\u201337\u2009weeks of pregnancy versus postpartum baseline, using motion analysis to identify high\u2010risk postures and musculoskeletal strain during surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Five microvascular surgeons were assessed at 36\u201337\u2009weeks of pregnancy and again postpartum while performing microvascular procedures in the operating room. Video recordings were analyzed using Kinetica Labs motion analysis software to evaluate joint angles, postural deviations, and static posture duration. Ergonomic risk was classified using criteria from validated Rapid Entire Body Assessment (REBA) and Rapid Upper Limb Assessment (RULA) tools.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the third trimester, motion analysis identified a significant increase in time spent in high\u2010risk positions compared to postpartum baseline data. The elbow joint demonstrated the highest percentage of time in unsafe positioning during pregnancy (59% unsafe vs. 20% at baseline), followed by the neck (50% unsafe vs. 20% at baseline) and the knee (26% unsafe vs. 5%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pregnancy presents distinct and measurable ergonomic challenges for microvascular surgeons, with increased time spent in high\u2010risk postures compared to postpartum performance. These findings underscore the need for tailored ergonomic interventions, equipment modifications, and institutional support to protect surgeon health and optimize intraoperative performance during pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>4.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70291","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T12:14:56Z","timestamp":1766146496000},"page":"2161-2168","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Balancing Act: Ergonomic Challenges for Pregnant Microvascular Surgeons in the Operating Room"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1143-1290","authenticated-orcid":false,"given":"Nina","family":"Patel","sequence":"first","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology\u2013Head and Neck Surgery University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aarti","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology\u2013Head and Neck Surgery University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8986-5961","authenticated-orcid":false,"given":"P. Daniel","family":"Knott","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology\u2013Head and Neck Surgery University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea M.","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology\u2013Head and Neck Surgery University of California, San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,19]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.134.9.1011"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-003-8824-3"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-019-2557-5"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-017-4787-1"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apergo.2016.12.006"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26859"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2020.10.027"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2005.10.002"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1589\/jpts.27.279"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.5830\/CVJA-2016-021"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119820260.ch4"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27496"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/oto2.126"},{"key":"e_1_2_10_15_1","volume-title":"StatPearls [Internet]","author":"Lopez\u2010Gonzalez D. 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