Contents
Unfortunately, pregnancy can be accompanied by pain in the abdomen, which is associated not only with an increase and hypertonicity of the uterus. Sometimes its course is complicated by various diseases of the abdominal organs. One of the most insidious among them is acute appendicitis.
In pregnant women, appendicitis proceeds a little differently, masquerading as any other conditions and an enlarged uterus. And the risk of its severe complications doubles, because we are talking about the mother and child. Therefore, it is so important to correctly and carefully evaluate all the data that speak in favor of acute appendicitis during pregnancy.
Signs and symptoms of appendicitis during pregnancy
In most pregnant women, appendicitis begins gradually. Its clinical manifestations develop within 6-12 hours. The disease is characterized by a progressive layering of symptoms and a deterioration in the condition of the pregnant woman.
Symptoms of acute appendicitis during pregnancy:
Abdominal pain. Its localization is determined by the gestational age and the size of the enlarged uterus. After all, the localization of the caecum with the appendix depends on this. In the initial stages (up to 3 months), pain occurs in the right iliac region. In later terms, pregnant women complain of its appearance in the right lateral region of the abdomen opposite the navel. A very important point: if the pain in the abdomen initially arose in any other area, and after a while it was finally localized in its right sections, this is most likely acute appendicitis;
Nausea and vomiting. Very often, these symptoms can be misleading and underestimated. This applies to pregnant women with toxicosis of the first half of pregnancy. Therefore, the combination of abdominal pain with vomiting should always be alert to the possibility of developing acute appendicitis;
temperature response. The temperature rise is usually not significant – up to 38,0 ° C;
When examining pregnant women with appendicitis, dryness and white coating of the tongue are determined. There may be a characteristic blush on the cheeks;
Palpation of the abdomen is the main guideline for making a diagnosis. At the same time, local pain is determined in the right iliac or lateral sections with pressure. If there is muscle tension and increased pain after a sharp removal of the hand from the abdomen during pressure (Shchetkin-Blumberg symptom), the diagnosis becomes obvious;
In all cases, they are guided by the indicators of a blood test. An increase in the level of leukocytes (leukocytosis) and a shift of the leukoformula to the left (an increase in the percentage of immature forms of leukocytes) speaks in favor of acute appendicitis during pregnancy.
Consequences of appendicitis during pregnancy
Due to their special status in pregnant women, the diagnosis of acute appendicitis in them is subject to reliable confirmation. After all, an incorrect assessment of symptoms will lead to unnecessary surgery, which can affect the development of the fetus. But on the other hand, if pregnant women with appendicitis are observed for a long time, which happens very often, this can lead to destructive changes in the appendix.
The most insidious thing in this situation is that when the appendix necroticizes, nerve receptors are among the first to die. Therefore, pregnant women feel a certain relief, which makes them refuse the proposed operation because of the concern for their baby. Everything will become clear only after the rupture of the appendix and the development of formidable complications that are extremely dangerous for both the pregnant woman and the child:
Peritonitis with severe intoxication. In pregnant women, it often ends in a septic condition and the impossibility of further bearing a child;
Formation of periappendicular or abscesses of other localization;
Pylephlebitis – purulent inflammation of the veins in the hepatic system;
The scenario develops in a completely different way with a timely operation. Such pregnant women recover quickly in the postoperative period. Very rarely, there are complications from pregnancy and the fetus.
What to do?
If a pregnant woman has a stomach ache, in any case, she must see a doctor. She should be examined by two specialized specialists: an obstetrician-gynecologist and a surgeon. In all doubtful cases, hospitalization in a surgical or obstetric-gynecological hospital is indicated. Pregnant women with suspected appendicitis are monitored for 12 hours. During this time, the necessary diagnostic studies are carried out and the issue of further tactics is decided. In no case should you administer or take painkillers on your own. They can further confuse the clinical picture. It is only advisable to use antispasmodics (no-shpa, papaverine, riabal), both for the purpose of pain relief and for differential diagnosis with various colic and uterine hypertonicity.
Is the appendix removed during pregnancy?
If the diagnosis of acute appendicitis cannot be ruled out, surgical treatment is urgently performed. Appendectomy in pregnant women is the same forced operation as in any other case. The technical aspects of its implementation are similar.