Manifestations of acute appendicitis semiotics in dependence from its location and trimester of pregnancy
DOI:
https://doi.org/10.11603/2414-4533.2018.2.9190Keywords:
acute appendicitis, pregnancy, immunoglobulins, interleukins, cryoglobulins.Abstract
The aim of the work: to analyze the clinical course of acute appendicitis and laboratory parameters of inflammation in pregnant women, depending on the location of the appendix and the trimester of pregnancy to determine the treatment and prevention of complications during pregnancy.
Materials and Methods. The clinical course and paraclinical parameters were evaluated in 258 pregnant women with acute appendicitis who were treated at the clinical clinics in Kyiv and 391 pregnant women without acute surgical pathology, which made the comparison group. Among the biochemical data, the level of immunoglobulins M, G, A, E, circulating immune complexes, tumor necrosis factor, cryoglobulins, procalcitonin, interleukin 1, 2 as well as parameters of non-specific resistance of the organism and adaptive immunity were investigated.
Results and Discussion. In the first trimester, 68.57 % of patients noted a sudden onset of pain, 63.68 % in the second and 69.7 % in the third. The combination with nausea and single or double vomiting is set in 77.14 %, 47.89 % and 36.36 %, respectively. Signs of endogenous intoxication were found in 20.0 %, 45.26 %, 57.58 % of pregnant women in three trimesters, respectively. In the second and third trimesters of pregnancy, the determination of pain at the points of McBurney, Lanca was ineffective in 90 % of cases. Among the biochemical indicators, the increase in the content of procalcitonin was 4 times, the concentration of TNF was 2.74 times, the IL-1 content was 1.6 times, the content of the CIC was 1.46, and the levels of IgM and IgG (2.11 times and 1.37 times), respectively), relative to the indicators of the control group.
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