Improving the Diagnosis and Treatment of Acute Appendicitis in Pregnant Women
Objective: to improve the diagnosis of acute appendicitis and the results of its treatment in pregnant women. Subjects and methods. Two hundred and forty-three pregnant women sent with the diagnosis of acute appendicitis were followed up. Clinical and laboratory methods were used to diagnose acute a...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
2012-10-01
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| Series: | Общая реаниматология |
| Online Access: | https://www.reanimatology.com/rmt/article/view/201 |
| Summary: | Objective: to improve the diagnosis of acute appendicitis and the results of its treatment in pregnant women. Subjects and methods. Two hundred and forty-three pregnant women sent with the diagnosis of acute appendicitis were followed up. Clinical and laboratory methods were used to diagnose acute appendicitis. One hundred and thirty-nine pregnant women were operated on, of them 47 underwent laparotomy, two-step abdominal sanitation, and drainage for general purulent peritonitis. Results. The authors have elaborated and introduced into practice a diagnostic algorithm for acute appendicitis in pregnant women, a procedure to estimate an electrical cecal cupula potential that allows its location to be specified, improved laparo-scopic techniques, and introduced a procedure long-term autonomous intestinal motility stimulation, which fails to affect uterine tone in pregnant women. An antibiotic cocktail that has an effect on different types of the microflora has been proposed to sanitize the abdomen in pregnant women with complicated acute appendicitis. Conclusion. Examination of pregnant women with suspected appendicitis according to the proposed algorithm makes it possible to rule out diagnostic errors, to specify indications for appendectomy, to correctly choose an access, by estimating the electrical potential of the cecal cupula, to guard against the development of peritonitis, by administering the proposed antibiotic cocktail, to implement a package of measures for the detoxification and early recovery of intestinal motility, and to prevent antenatal fetal death. The mortality rates in pregnant women with acute appendicitis were 0.7%. Key words: acute appendicitis in pregnant women. |
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| ISSN: | 1813-9779 2411-7110 |