Ultrasound screening of acute appendicitis in pregnant women

Authors

  • M. M. Stets O. Bohomolets National Medical University, Kyiv
  • N. V. Voytyuk O. Bohomolets National Medical University, Kyiv
  • V. M. Chernenko O. Bohomolets National Medical University, Kyiv
  • V. V. Finochko O. Bohomolets National Medical University, Kyiv

DOI:

https://doi.org/10.11603/2414-4533.2021.4.12725

Keywords:

acute appendicitis, ultrasound screening, pregnant women, laparoscopy, analysis of methods

Abstract

The aim of the work: prevention of premature births by improving diagnostic methods using ultrasound screening and the choice of surgical tactics in pregnant women with acute surgical pathology depending on the results of screening.

Mrterials and Methods. A retrospective review of medical cases and outpatient charts of patients with suspected acute surgical pathology of the abdominal cavity was conducted in the Kyiv City Clinical Hospital No. 1 from 2016 to 2021.

Results and Discussion. All pregnant women underwent the necessary clinical, laboratory and instrumental research methods in accordance with the updated clinical protocols for the provision of surgical care to pregnant women. In some cases, magnetic resonance ima­ging and computed tomography were performed to detail the spread of the pathological process and, accordingly, the choice of surgical intervention.

Features of the clinical picture of AA are due to anatomical and physiological features of pregnant women. With increasing gestational age, we observed a more pronounced change in the clinical manifestations of AA with a more rapid course of the disease. Indicators of laboratory researches have a certain value in diagnosis of AA in pregnant women. Leukocytosis, neutrophilic shift of the leukocyte formula to the left, lymphocytopenia indicate in favor of appendicitis.

Tocolytic therapy has been used both in preoperative preparation and intraoperatively, which significantly affects the prevention of premature birth and pregnancy complications.

Postoperative complications were not observed in this population.

Detailing the diagnosis in pregnant women with acute surgical pathology using the latest diagnostic methods, gave the opportunity to choose tactics and methodology of surgical treatment. Ultrasound scanning is highly sensitive and specific in 71 % of pregnant women with acute appendicitis.

The introduction of minimally invasive methods has made it possible to reduce the number of pregnant women in the hospital and their use in the third trimester of pregnancy (8 % of the total number of operated).

References

Aasvang, E.K., Gmaehle, E., Hansen, J.B., Gmaehle, B., Forman, J.L., Schwarz, J., ..., & Kehlet, H. (2010). Predictive risk factors for persistent postherniotomy pain. Anesthesiology, 112 (4), 957-969. DOI: 10.1097/ALN.0b013e3181d31ff8.

Guttman, R., Goldman, R.D., & Koren, G. (2004). Appendicitis during pregnancy. Can. Fam. Physician, 50, 355-357.

Bickell, N.A., Aufses, A.H. Jr, Rojas, M., & Bodian, C. (2006). How time affects the risk of rupture in appendicitis. J. Am. Coll. Surg., 202 (3), 401-406. DOI: 10.1016/j.jamcollsurg.2005.11.016.

Pedrosa, I., Levine, D., Eyvazzadeh, A.D., Siewert, B., Ngo, L., & Rofsky, N.M. (2006). MR imaging evaluation of acute appendicitis in pregnancy. Radiology., 238 (3), 891-899. DOI: 10.1148/radiol.2383050146.

Kanal, E., Barkovich, A.J., Bell, C., Borgstede, J.P., Bradley, W.G. Jr, Froelich, J.W., ..., & Sass, N. (2007). ACR guidance document for safe MR practices: 2007. Am. J. Roentgenol., 188 (6), 1447-1474. DOI: 10.2214/AJR.06.1616.

Garcia, E.M., Camacho, M.A., Karolyi, D.R., Kim, D.H., Cash, B.D., Chang, K.J., & Carucci, L.R. (2018). ACR Appropriateness criteria: right lower quadrant pain-suspected appendicitis. J. Am. Coll. Radiol., 15 (11S), S373-S387. DOI: 10.1016/j.jacr.2018.09.033.

Donkervoort, S.C., & Boerma, D. (2011). Suspicion of acute appendicitis in the third trimester of pregnancy: pros and cons of a laparoscopic procedure. JSLS, 15 (3), 379-383. DOI: 10.4293/108680811X13125733356837.

Gaitán, H.G., Reveiz, L., & Farquhar, C. (2011). Laparoscopy for the management of acute lower abdominal pain in women of childbearing age. Cochrane Database Syst. Rev., 19 (1), CD007683. DOI: 10.1002/14651858.CD007683.pub2.

Downloads

Published

2022-02-18

How to Cite

Stets, M. M., Voytyuk, N. V., Chernenko, V. M., & Finochko, V. V. (2022). Ultrasound screening of acute appendicitis in pregnant women. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (4), 95–98. https://doi.org/10.11603/2414-4533.2021.4.12725

Issue

No. 4 (2021)

Section

EXPERIENCE OF WORK

License

Copyright (c) 2022 Hospital Surgery. Journal named by L.Ya. Kovalchuk

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).