Appendicitis - Inflammation of the Cell-shaped Girl's Cell Process - one of the most frequent surgical diseases of the abdominal organs. The incidence of acute appendicitis in pregnant women is higher than that of other women. At the same time, the disease is most often (in more than 60% of cases) the disease falls on the first half of pregnancy, mainly for the first 10 weeks.
Content
Causes of the disease
Acute appendicitis can develop on any time
pregnancy and often ends with a destructive process as a result
which occurs purulent melting of a heart-shaped process and surrounding
fabrics. Such a frequency of appendicitis and flow features
Diseases are associated with physiological changes occurring in the body
Women during pregnancy:
- Because of the growing uterus, the blind intestine and a worm-shaped process shift up
and the duck;
- Next to constipation, often arising during pregnancy leads to stagnation
intestinal content and increase microflora hypother;
- There is a restructuring of the immunity system, including lymphoid
The apparatus of the blind intestine;
- Immune (protective) body forces weakened during pregnancy,
Changes in the properties of blood occur, there is a predisposition to vascular
Thrombosis and spasms.
How the inflammatory process develops? Causative agent
Diseases is a mixed microflora (intestinal sticks, staphylococci,
streptoenterococci, anaerobes), which are introduced into the wall of the draft
The process is directly from his lumen, that is, enterogenic. It
Promotes stagnation of content in a process caused by various reasons
(inflection, compressed and t.D.). At the same time, intricultural pressure increases in
the process and the blood stagnation occurs in the vessels of the wall of the process, which leads to
deterioration of the power of the process of process and reinforced reproduction of bacteria.
A significant role in the development of inflammation is played by predisposing factors -
Nutrition and various options for the abdominal process.
Symptoms of appendicitis
Distinguish simple (t.E. catarler) and destructive
(phlegmonous, gangrenous and perforative) form of appendicitis. All of them
are the stages of the development of a single process, and for their occurrence
The progressive course of the disease requires a certain time: for
Catarial appendicitis - 6-12 hours, for phlegmonous - 12 - 24 hours, for
gangrenous - 24-48 hours; Later, the perforation of the process, when
which the content of the intestine falls into the abdominal cavity.
Special danger of appendicitis during pregnancy is due
Near the reasons: displacement up the heart-shaped process and
Selinic with increasing pregnancy, decreasing
Opportunities for the formation of adhesions and restrictions of the inflammatory process in the abdominal
cavities.
Appendicitis manifestations in many ways depend on pathological
Change in the process, as well as from its location in the abdominal cavity. To tech
pores while the inflammatory process is limited to the process itself without moving on
peritoneum - a film of connective tissue, covering walls and abdominal organs
cavities, disease manifestations do not depend on its localization (location in
abdominal cavity relative to other organs) and expressed pain in the top
Third of belly, which gradually shift down, in the right half of the abdomen. At
This may appear nausea, vomiting. Abdominal pain can be insignificant and
Arrive not only in the right iliac region, but also in other belly departments.
Often painfulness during the inspection is detected not immediately and localizes
significantly above the uterus, often the greatest pain is determined in the right
Lumbar region. Characterist Increased pain in the position lying on the right side,
Due to the pressure of a pregnant uterus on an inflamed focus. With further
The development of the inflammatory process appears soreness in the right iliac
Areas - in the lower parts of the abdomen or higher, right up to the hypochondrium, depending
from the degree of displacement process with the uterus. Symptoms of irritation of peritoneum
(soreness with a sharp removal of a hand adultering on the front abdominal
the wall) is missing in pregnant women or poorly expressed due to the stretching of the abdominal
Walls. It should be borne in mind that all the symptoms may be undeveloped and
appear late.
The development of peritonitis (inflammation of the peritoneum covering organs and
the walls of the abdominal cavity) more often happens in a later date of pregnancy, t.
To. Conditions for the odds of the inflammatory process deteriorate. Under development
peritonitis increases pulse, the body temperature rises, vomiting,
Abdominal bloating appears, difficulty breathing, shortness of breath.
Diagnosis of appendicitis
To diagnose appendicitis, in addition to inspection and study data
Complaints, apply laboratory, instrumental examination. So, overall analysis
Blood shows an increase in the number of leukocytes.
In the initial period of pregnancy, the diagnosis of appendicitis is small
It differs from those non-empty, but it happens difficult: abundance
Complaints in women in these deadlines leads to the fact that they are not paid due
Attention. Characteristic of pregnancy constipation, nausea, vomiting and t.NS. can not
Considering as signs of appendicitis in the absence of other symptoms.
The task of the doctors includes to distinguish appendicitis not only from
manifestations of pregnancy, but also from diseases such as pyelonephritis,
Urolithiasis, cholecystitis, intestinal colic, gastritis, food poisoning.
Appendicitis manifestations can resemble such complications of pregnancy as
Late Gestozing, Threat of Pregnancy Interrupt, Premature Pulling
Placets.
To diagnose acute appendicitis in pregnant women
Time is used techniques such as ultrasound research,
Doppler study of blood flow in a worm-shaped process and laparoscopy -
Inspection of the abdominal cavity with the help of special optical devices introduced
through a small incision of the front abdominal wall.
Possible complications in appendicitis in pregnant women
After removing appendicitis in pregnant women in 17% arise
Obstetric and surgical complications. Among the surgical notes
Perforation (hole formation in a heart-shaped process), septic shock.
For some options, the arrangement of the process can develop right-hand
Pureropneumonia. Among other complications allocate postoperative
infectious processes, intestinal obstruction.
Treatment of appendicitis
Treatment of pregnant women with acute appendicitis on any time
Pregnancy is held operational. However, even timely operation is not
always avoids complications. Prevention of complications of appendicitis in
Pregnancy time is aimed at preserving pregnancy; For this apply
Tocolics - drugs relaxing muscles of the uterus. For prophylaxis
infectious complications after appendectomy in pregnant women are recommended
Antibacterial therapy.
Maintaining pregnant women in the postoperative period, prevention and
Therapy of complications of acute appendicitis should be carried out taking into account a number
features. After the operation, the load and ice on the stomach are observed
caution in the expansion of the regime in the choice of funds aimed at combating
the intestinal paresis is a phenomenon in which the intestine does not reap statter, that is «does not work». Used physiotherapy: diathermy (deep warming
tissue currents of high frequency and high power obtained from special
apparatus) region of solar plexus (at the beginning of pregnancy) or lumbar
Areas (at Late Timing), which not only help cope with paresis
intestine, but also contribute to pregnancy. Also applied
Reflexotherapy, in particular, acupuncture.
Prevention of premature interruption of pregnancy after
The operations consists in a burden of preservation of beddown and in use
appropriate treatment: patient prescribe soothing drugs, vitamins with
and e, with tangible cuts in the uterus - candles with papaverine or magnesium
Sulfate intramuscularly, endonazal (in the nasal cavity) Vitamin electrophoresis
IN.
If childbirth came in the early postoperative period, their
Maintaining is distinguished by special care. In this case, apply tight binting
Belly, full-fledged anesthesia with wide use of antispasmodics. IN
birth is constantly carried out by the prevention of intrauterine hypoxia of the fetus. Period
The expulsion of the fetus is shortened by dissection of crotch or overlay
obstetric tongs.
After discharge from the hospital of all pregnant women who have undergone
Appandycite includes risk risk in the threat of premature interrupt
pregnancy that may occur after a significant time after
Operations.
The fruit in these women is considered as intrauterine
infection. Doctors carefully monitor its development, the condition of blood flow in
Placet and Fetal Vessels (Uzp, Hormonal Study, FKG, ECG). At
The manifestations of the intrauterine suffering of the fetus women hospitalize and spend
Appropriate therapy: Actovegin, Trental,
ATP, Cocarboxylase, Folic and Ascorbic
Acids, 40% glucose, low molecular weight dextre, vitamins,
as well as Essence.
No matter how far in time, the childbirth from surgical
interventions, they are always conducted with sufficient alertness due to
Increased risk of complications: Anomalies of the generic forces, hypoxia
Fetal (lack of oxygen), bleeding in postpartum and early postpartum
Periods.
After extracting from the hospital, the woman undergoing appendicitis,
must regularly visit an obstetrician-gynecologist, t.To. She has increased risk of development
such pathologies of pregnancy as the threat of premature births, detachment
Placets. The doctor will closely monitor the state of mother health and
development of fruit.
In any case, appendicitis is a disease that only is sick
once in life, and the outcome of the disease depends not only from doctors, but also from
Your faith and hope for the best.
