Acute surgical abdomen in pregnancy
Keywords:
acute abdomen, complications of pregnancy, surgeryAbstract
Introduction: acute surgical abdomen is an entity that, if not resolved surgically, causes death in most cases and, in pregnant women, it is of special interest since the symptoms and signs do not appear in a typical manner. Objective: to characterize the behavior of acute surgical abdomen in pregnant women in the gynecology service of the General Teaching Hospital "Octavio de la Concepción y de la Pedraja" in the municipality of Baracoa, Guantánamo. Method: a retrospective cross-sectional descriptive study of 25 clinical histories of pregnant patients who presented an acute surgical abdomen in the period from November 1996 to November 2005. Results: the group of 20-29 years of age had 64% of frequency followed by the group of 15-19 years, with 36%. Appendicitis was the most frequent cause of acute surgical abdomen with 10 cases, followed by acute cholecystitis and complicated ovarian cyst, both with 5 patients. This entity appeared in 68% of the patients who were in their second trimester of pregnancy, followed by the pregnant women of the third trimester, with 28%. There were symptoms of abdominal pain and tachycardia in 100% of the cases; nausea in 60%, and contracture and peritoneal reaction in 80%. Urosepsis was noted as a complication in 12%, sepsis of the surgical wound in 4%, for a morbidity rate of 20%, with a maternal mortality rate of 4%. Conclusions: the acute surgical abdomen presented with an incidence of 1.9 per 1000 pregnant women and more frequent in the ages between 20-29 years. Acute appendicitis, acute cholecystitis and complicated ovarian cyst are the diseases that most occurred in the acute surgical abdomen during the second trimester of pregnancy. The most frequent symptoms were: abdominal pain, contracture and peritoneal reaction. The highest percentage of cases was positive in the clinical diagnosis.
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