Abstract
Objectives
The obstetrician often has a difficult task in diagnosing and managing the acute abdomen
in pregnancy. A reluctance to operate during pregnancy adds unnecessary delay, which
may increase morbidity for both mother and fetus. In this study, we present our experience
in pregnant patients with acute abdomen.
Study design
Pregnant patients with acute abdomen requiring surgical exploration were enrolled
from 2007 to 2010. Demographics, gestational age, symptoms, fetal loss, preterm delivery,
imaging studies, operative results, postoperative complications and histopathologic
evaluations were recorded. Ultrasound (US) and magnetic resonance (MR) imaging studies
were evaluated. Data analyses were performed with Microsoft Excel and statistical
evaluations were done by using Student's t-test.
Results
There were 20 patients with a mean age of 32 years. The rate of emergency surgery
was seen to be significantly higher in the second trimester (p < 0.05). Most common symptoms were abdominal pain (100%) and nausea (80%). US was done
in all patients while MR imaging was used in 30%. However, US findings were consistent
with surgical findings in only 55%, while MR was successful in assigning the correct
diagnosis in 83.3%. Appendicitis and adhesive small bowel obstruction were the most
common etiologies causing acute abdomen (30% and 15%, respectively). All patients
tolerated surgery well, and postoperative complications included wound infection,
10%, preterm labor, 5%, and prolonged paralytic ileus, 5%. One patient died from advanced
gastric carcinoma and the only fetal death was seen in this case.
Conclusions
Prompt diagnosis and appropriate therapy are crucial in pregnant with acute abdomen.
The use of US may be limited and CT is not desirable due to fetal irradiation. MR
has thus become increasingly popular in the evaluation of such patients. Adhesive
small bowel obstruction should be kept in mind as an important etiology.
Keywords
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Article info
Publication history
Published online: July 29, 2011
Accepted:
July 11,
2011
Received in revised form:
June 14,
2011
Received:
May 12,
2011
Identification
Copyright
© 2011 Published by Elsevier Inc.
