Appendicitis and pregnancy


  • Causes of disease
  • Symptoms of appendicitis
  • Diagnosing appendicitis
  • Possible complications of appendicitis in pregnant
  • Treatment for appendicitis

  • Causes of disease

    Acute appendicitis can occur at any stage
    pregnancy and often ends destructive process, as a result of
    which occurs purulent fusion of the appendix and the surrounding
    tissues. This incidence of appendicitis and peculiarities of
    diseases associated with the physiological changes that occur in the body
    women during pregnancy:

    • due to the growing uterus cecum and appendix are shifted upwards
      and outwards;
    • tendency to constipation often occurs during pregnancy, it leads to stagnation
      the contents of the intestine and increase pathogenic microflora;
    • a restructuring of the immune system, including lymphoid and
      apparatus cecum;
    • during pregnancy weakened immune (defense) of the organism,
      is changing the properties of the blood, there is a predisposition to vascular
      thrombosis and spasm.

    How to develop an inflammatory process? The causative agent
    disease is a mixed microflora (Escherichia coli, Staphylococcus,
    streptoenterokokki, anaerobes), which are embedded in the wall of the appendix
    process directly from its lumen, i.e. by enterogenous. the
    It contributes to stagnation of the contents in a process caused by various reasons
    (Bend, compression, etc.). This increases the pressure in the intraluminal
    process and there is stagnation of blood in the vessels of the appendix wall, which leads to
    deterioration of the power process the walls and enhanced growth of bacteria.
    An important role in development of an inflammation play a predisposing factors -
    Food and variants process location in the abdominal cavity.

    Symptoms of appendicitis

    There are simple (eg bluetongue) and destructive
    (Abscess, gangrenous and perforated) forms of appendicitis. All of them
    are stages of a single process, and they occur when
    the progressive course of the disease at a specific time for
    catarrhal appendicitis - 6-12 hours, for the abscess - 12 - 24 hours for
    gangrenous - 24-48 hours; later it may come and perforation of the appendix, at
    Bowel content that enters the abdominal cavity.

    Appendicitis and pregnancy
    Special hazards caused by appendicitis in pregnancy
    a number of reasons: a shift upwards of the appendix and
    omentum with increasing pregnancy, decrease
    formation of adhesions capabilities and limitations of the inflammatory process in the abdominal

    The manifestations of appendicitis largely depend on the pathological
    a change in a process, as well as its location in the abdominal cavity. Until
    long as the inflammatory process is limited by the process, without having to go on
    peritoneum - a film of connective tissue that covers the abdominal wall and organs
    cavity manifestations of the disease do not depend on its location (location in
    abdominal cavity relative to other organs), and expressed pain at the top
    third belly, which gradually displaced downward, the right half of the abdomen. at
    This may be nausea, vomiting. Abdominal pain may be minor and
    occur not only in the right iliac region, but also in other parts of the abdomen.
    Often the pain during the inspection revealed no direct and localized
    significantly higher than the uterus, often the greatest pain is defined in the right
    the lumbar region. Characteristically increased pain when lying on his right side,
    due to the pressure of the pregnant uterus on the focus of inflammation. On further
    the development of the inflammatory process occurs pain in the right iliac
    region - in the lower abdomen or above, up to the hypochondrium, depending
    the degree of offset ridge uterus. Symptoms of peritoneal irritation
    (Pain during heavy suspension arms, presses on the abdominal
    wall) absent in pregnant or are poorly expressed because of an abdominal strain
    wall. Note that all of the symptoms may be unexpressed and
    appear later.

    The development of peritonitis (inflammation of the peritoneum covering the bodies and
    abdominal wall) usually occurs in the later stages of pregnancy, that is.
    a. the conditions for distinguishing inflammation worsen. With the development of
    peritonitis increases heart rate, increased body temperature, becomes more frequent vomiting,
    appear bloating, difficulty breathing, shortness of breath.

    Diagnosing appendicitis

    For the diagnosis of appendicitis, in addition to these inspection and study
    complaints, use laboratory, instrumental examination. Thus, the overall analysis
    It shows an increase in blood leukocyte number.

    In the initial stages of pregnancy diagnosis of appendicitis little
    differs from that in non-pregnant, but she is constrained: the abundance
    in these terms of complaints in women leads to the fact that they were not given proper
    attention. Specific to pregnancy constipation, nausea, vomiting, etc. can not
    considered as symptoms of appendicitis in the absence of other symptoms.

    The task of physicians to distinguish appendicitis includes not only
    manifestations of pregnancy, but also by diseases such as pyelonephritis,
    urolithiasis, cholecystitis, intestinal colic, gastritis, food poisoning.
    The manifestations may resemble appendicitis and complications of pregnancy such as
    late preeclampsia, threatened miscarriage, premature detachment

    For the diagnosis of acute appendicitis in pregnant women is currently
    currently used techniques such as ultrasound,
    Doppler blood flow in the appendix and laparoscopy -
    examination of the abdominal cavity with the help of special optical devices introduced
    through a small incision anterior abdominal wall.

    Possible complications of appendicitis in pregnant

    After removal of appendicitis in pregnant women occur in 17%
    obstetric and surgical complications. Among the surgical mark
    perforation (hole formation in the appendix), septic shock.
    In some embodiments, the process can develop location-sided
    pleuropneumonia. Among other complications recovered postoperative
    infectious processes, intestinal obstruction.

    Treatment for appendicitis

    Treatment of pregnant women with acute appendicitis at any stage
    pregnancy is carried out promptly. However, even surgery is not timely
    always possible to avoid complications. Preventing complications of appendicitis
    pregnancy is aimed at the preservation of pregnancy; apply for this
    tocolysis - drugs, relaxing muscles of the uterus. To prevent
    infectious complications after appendectomy in pregnant women is recommended
    antibiotic therapy.

    Keeping pregnant women in the postoperative period, and prevention
    complications of therapy of acute appendicitis should be carried out taking into account the number of
    features. After the surgery, do not impose the goods and ice on the abdomen is observed
    caution in the expansion mode in the choice of means to combat
    paresis of the intestine - a phenomenon in which the intestines do not perestaltiruet, that is "not working". Used Physiotherapy: diathermy (deep heat
    tissue of high frequency currents and a large force derived from a special
    machine) the solar plexus (early pregnancy) or lumbar
    area (in later stages), which not only help to cope with paresis
    bowel, but also help maintain pregnancy. also used
    reflexology, in particular, acupuncture.

    Prevention of premature termination of pregnancy after
    operation is more committed to the preservation of bed rest and the use of
    appropriate treatment: a patient is prescribed anti-anxiety drugs, vitamins C
    and E, with notable contractions - candles with papaverine or Magnesium
    sulfate intramuscularly endonasal (the nasal cavity) electrophoresis vitamin

    Appendicitis and pregnancy
    If the birth came in the early postoperative period, and their
    maintaining different special care. In this case, use tight bandaging
    belly full anesthesia with extensive use of antispasmodics. AT
    childbirth are constantly carrying out the prevention of intrauterine fetal hypoxia. Period
    fetal expulsion shortened by a dissection of the perineum or the imposition of

    After discharge from the hospital all pregnant women who underwent
    appendicitis include risk by the threat of premature termination
    pregnancy, which can occur after a considerable time after the

    The fruit of these women are considered as intra-endured
    infection. Doctors are closely monitoring its development, the state of blood flow in
    placenta and fetal vessels (SPDs, hormonal research, PCG, ECG). at
    manifestations of intrauterine fetal suffering woman hospitalized and spend
    appropriate therapy: prescribe Aktovegin, Trental,
    ATP kokarboksilazu, folic and ascorbic
    acid, 40% glucose, low molecular weight dextran, vitamins,
    and Essentiale.

    How far have time nor defended by surgical births
    intervention, they always lead to sufficient vigilance in connection with the
    an increased risk of complications anomalies tribal forces, hypoxia
    fetus (lack of oxygen), bleeding in the postpartum and early postpartum

    After discharge from the hospital women who have had appendicitis,
    should regularly visit the obstetrician because she has an increased risk of
    such pathologies of pregnancy, the threat of premature birth, placental
    placenta. The doctor will closely monitor the health of the mother and
    fetal development.

    In any case, appendicitis - is a disease that only sick
    once in a lifetime, and the outcome depends not only on doctors, but also by
    your faith and hope for the best.

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