вторник, 9 октября 2012 г.

Pregnancy and appendicitis

Appendicitis during pregnancy occurs in 0,03-5,20% of cases. Perforation червеобразного process is observed in 14% of surgical interventions, made in connection with a preliminary diagnosis of appendicitis during pregnancy, and is celebrated in 25-43% of patients with a confirmed diagnosis. In the vast majority of cases, the duration of disease more than 24 hours.

As a whole in the first half of pregnancy accounts for 3/4 of all the observations of acute appendicitis. The most often appendicitis occurs in I (19-32%) and II trimestrah (44-66%) of pregnancy, less than in the III trimester (15-16%) and the postpartum period (6-8%).

Destructive forms of appendicitis are more likely to arise in the III trimester of pregnancy and the postpartum period, and perinatal outcomes are worse, if the disease developed in the second trimester of pregnancy.

During pregnancy the diagnosis of acute appendicitis, as well as other diseases accompanied by symptoms of "acute abdomen", more complicated than in non-pregnant. Almost 2/3 of patients with appendicitis in our country, turned for help to the women's consultation, were sent to the maternity hospital with a diagnosis of threat of premature termination of a pregnancy. In General in the pre-hospital stage, the correct diagnosis of acute appendicitis was installed only in 42.9% of pregnant women. Thus, more than 50% of the observations of appendicitis in pregnant women was allowed diagnostic error, which resulted in the non-core hospitalization of patients and the postponement of transactions. In connection with the difficulties of clinical diagnosis of acute appendicitis in every third pregnant appendectomy was performed more than 24 hours from the onset of the disease. Keeping pregnant with a sharp pain in his stomach and suspicion on the surgical pathology before establishing of the final diagnosis is recommended at the same time obstetrician-gynecologist, surgeon.

For appendicitis in early pregnancy differs little from the flow of appendicitis without pregnancy. 

More dangerous occurrence of appendicitis in later pregnancy, when the already large size of the pregnant uterus pushes the blind gut, and together with it and червеобразный runner up, the old adhesions.

In more of the free part of the abdominal cavity, where it moved the caecum, conditions for differentiation of inflammatory hearth less favourable, than at the bottom, at its usual place, but because most likely develop a General inflammation of the peritoneum - peritonitis.

Pregnancy with appendicitis often not донашивается - is interrupted. When the signs of appendicitis pregnant, you should immediately send to the hospital. In acute appendicitis during pregnancy the patient should be operated on. After such an operation in early pregnancy the last successfully донашивается; later in the same period of pregnancy, closer to childbirth, after the surgical intervention can occur labour, deteriorates the course of the postoperative period.

Sometimes empty the uterus by a caesarean section, and at the same time produce destruction of червеобразного process

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