Symptoms of inflammation of appendicitis during pregnancy. Appendicitis during pregnancy. Symptoms and treatment Does appendicitis occur in pregnant women?

Pregnancy is a wonderful time in a woman’s life, associated with the anticipation of upcoming joy. The expectant mother can enjoy her interesting position and not allow herself to think about the bad. Unfortunately, this period of life is sometimes complicated by health problems. One of them is appendicitis during pregnancy. Is this disease dangerous? What treatment is required?

What you need to know about appendicitis?

Appendicitis is a disease characterized by the development of an inflammatory process in the appendix. In medical practice, it is also called the appendix. This appendage is considered a rudiment; in the process of human evolution, it has lost its primary functions, but sometimes it still makes itself felt. According to statistics, in 25% of the population of our planet the appendix becomes inflamed.

When pain discomfort appears, many begin to remember which side the appendicitis is on. Everyone without exception should know this, because it is impossible to delay dealing with this pathology. The inflamed appendix is localized in the area between the navel and the right iliac region.

Pregnant women may also experience this condition. Its development is largely due to its interesting situation. If you have severe pain in the abdominal area, you should not postpone your visit to the doctor. Even if such a symptom does not indicate inflammation of the appendix, it should not be ignored.

Types of appendicitis during pregnancy

There are two forms of this disease: catarrhal and destructive. In the first case, the rudiment increases in size, swelling appears, but the purulent contents do not leak out. The destructive variant of the pathology can be divided into several conventional types:

Causes of the disease

Appendicitis is a pathological process associated with inflammation of the appendix. The disease is twice as likely to worsen in pregnant women. There is a reasonable explanation for this.

As the fetus grows and develops, the uterus increases in size, as a result of which displacement of the appendix is often observed. This anomaly causes circulatory problems in the appendix and leads to exacerbation of inflammation.

Appendicitis during pregnancy also has other prerequisites for development. Pathogenic factors include the following:

Decreased protective function of the body.
Frequent constipation.
Displacement of the cecum.
Vasospasm.
Infectious processes in the body of a pregnant woman.

If we systematize the etiology of the disease, the leading role in its history belongs to poor nutrition and improper location of the appendix in the peritoneum. The most susceptible to appendicitis are people who are accustomed to eating dry food and who abuse indigestible foods.

What symptoms indicate pathology?

The first signs of appendicitis do not linger and begin to progress immediately after inflammation of the appendix. The clinical picture depends on the form of the pathology:

Catarrhal appendicitis develops within 6-12 hours.
The destructive option lasts from 12 hours or more.

In general, the signs of appendicitis in women differ in a standard pattern and develop progressively. The inflammatory process begins with the appearance of painful discomfort in the side. At an early stage, it can be of a pulling nature. This condition is gradually replaced by unbearable pain, which significantly worsens the patient’s quality of life. The woman's temperature rises.

The pain syndrome is colicky in nature, and its intensity depends solely on the duration of pregnancy. In the third trimester, such signs of appendicitis in women may resemble the onset of labor. At the beginning of pregnancy, such discomfort is tolerable on the legs, which often confuses the doctor when making a diagnosis.

Associated symptoms include the following:

Vomiting and nausea.
Signs of depression.
Abnormal stool.
Increased fatigue.
Noticeable decrease in working capacity.

It is important to understand that acute appendicitis and pregnancy are a dangerous combination, because the presence of a fetus inside the womb only aggravates the course of the pathology, thereby increasing the risk of complications. That is why it is important to know what signs accompany the disease, so that if it occurs you do not waste precious time.

How does appendicitis affect the fetus?

Appendicitis during pregnancy certainly affects the development of the fetus. This disease is especially dangerous in the second trimester. The most common complication is termination of pregnancy. In addition, unpleasant consequences include infection of the mother’s body and intestinal obstruction.

Very rarely, pregnant women are diagnosed with placental abruption. With timely diagnosis and quality therapy, pregnancy can usually be saved. With the development of the inflammatory process in the membranes, the child becomes infected, which necessarily requires antibacterial therapy.

Appendicitis during pregnancy: consequences of the disease

Symptoms of pathology should not be ignored. Even if doctors detect the disease in a timely manner, its consequences may be the most unexpected not only for the gastrointestinal tract, but also for the entire body. Here it is necessary to note the likelihood of the following pathologies:

Infectious processes in the body.
Intestinal obstruction.
Placental abruption.
Violation of contractile function of the uterus.
Multiple bleedings.
Fetal hypoxia.

Treatment of this disease involves removal of the inflamed appendix. This is a very dangerous procedure that can affect the quality of life of the mother in labor and provoke premature birth. That is why everyone should know which side appendicitis is on, so that if painful discomfort occurs, they can respond to the problem in a timely manner.

Typically, pregnancy after surgery is complicated, so all women with this diagnosis are observed for some more time in the gynecological department.

Diagnostic measures

Diagnosis of the disease in pregnant women is complex, that is, it is carried out in several stages.

Appendicitis was discovered during pregnancy. What to do?

The only effective way to eliminate inflammation is surgery. It is impossible to reduce the manifestation of pathology even with medications. The operation is usually performed using general anesthesia. In some cases, epidural anesthesia may be used. It involves pain relief in the legs and the surgical area itself.

The operation can be traditional or laparoscopic. Next, we will consider each option in more detail.

Laparoscopic surgery is considered minimally invasive, so it is used most often. During the procedure, the surgeon makes a small puncture in the abdominal cavity, through which a special tube with a camera at the end is subsequently inserted. After detecting inflammation, the doctor makes several more similar punctures. Through them, instruments are inserted for appropriate surgical procedures.

Removal of appendicitis is quick and painless. After laparoscopy, several small scars remain on the body, which completely disappear over time. This procedure is used extremely rarely. The thing is that not all medical institutions have the necessary equipment and devices to carry it out.

Traditional surgery means appendectomy. During the procedure, the doctor makes an incision of about 8 cm in the abdominal wall. After identifying the inflamed appendix, it is removed and the cavity is assessed for the presence of an abscess. When a pathology is detected, the doctor dries it through special drainage tubes, which are necessarily removed to the outside. After this, the incision is sutured. Approximately on the seventh day, the sutures are removed.

Only a doctor can decide which method to remove appendicitis during pregnancy. Reviews from many patients confirm the fact that laparoscopy is truly a minimally invasive and at the same time effective option for excision of the appendix. The punctures heal very quickly, after some time there are no traces of the operation left.

Many women are concerned about the question of whether conception after appendicitis is dangerous. According to doctors, if the inflamed appendix was removed through appendectomy, you can start thinking about adding to the family in six months. Pregnancy after laparoscopy is safe after 2 months.

Postoperative rehabilitation

The postoperative period in pregnant women requires increased attention from doctors and the prevention of possible complications. After surgery, women do not put ice on their abdomen to avoid harming the fetus. Doctors usually recommend a special gentle regimen for quick recovery.

Removal of appendicitis always involves the use of antibacterial therapy during the rehabilitation period. All drugs are selected individually, taking into account the woman’s condition and the duration of pregnancy.

Prevention of so-called premature birth is also carried out. The patient is placed on bed rest, proper nutrition and strict adherence to all doctor’s instructions. Sometimes sedatives are additionally prescribed. After discharge from the hospital, a woman automatically falls into a group at increased risk of spontaneous abortion.

After surgery, the condition of the fetus requires special attention. Doctors monitor its development and monitor the placenta. If any abnormalities in the condition of the fetus or a deterioration in the health of the expectant mother are detected, she is immediately sent to the hospital for further treatment.

If childbirth occurs a few days after the operation, it is carried out under special supervision. Doctors constantly monitor to ensure that the stitches do not come apart. During the delivery process, special attention is paid to the prevention of intrauterine hypoxia. Doctors, as a rule, reduce the time of the procedure itself by cutting the perineum.

Instead of a conclusion

Acute or chronic appendicitis during pregnancy poses a serious threat not only to the development of the fetus, but also to the health of the expectant mother. A timely visit to the doctor and a competently performed operation are the key to a positive outcome.
If painful discomfort occurs in the abdomen, which is accompanied by fever and vomiting, it is necessary to immediately call a team of medical professionals.
Is appendectomy removed during pregnancy? Yes, the only correct option for treating pathology is surgical intervention.
After the operation, a rehabilitation period begins. At this time, the woman is prescribed bed rest and antibacterial therapy.

We hope that the information presented in this article will be truly useful to you. Be healthy!

Is it possible to promptly recognize appendicitis in pregnant women, the symptoms of which do not manifest themselves as usual? Why does it occur?

There are many prerequisites for the occurrence of the inflammatory process, but the main one is an enlargement of the uterus, which causes a significant displacement of the internal organs, in particular the intestines. Constant poor circulation in the peritoneal area, which gradually increases, can cause inflammatory processes not only in the appendix, but also in other organs.

There are other reasons:

decreased general immunity;
displacement of the appendix location;
the appearance of frequent constipation as a consequence of poor nutrition;
individual anomaly of the location of the appendix.

Localization of pain in appendicitis

The appendix is an extension of the cecum, which is considered an atavism. It does not perform any functions, does not bear the load during the digestion process, and can become inflamed and cause big problems. It is located in the lower abdomen on the right; pain during its inflammation is most often localized there, but its accurate diagnosis is sometimes quite difficult.

Despite the signs of appendicitis in women during pregnancy, it is impossible to determine the disease and make a diagnosis only from their words. Difficulties with diagnosis arise because the growing fetus gradually displaces all organs, so it is impossible to say with certainty that the pain is for this reason.

Complicating diagnosis is the fact that it may not be located in the same place in different people. In addition, at the early stage of the inflammatory process, the pain is usually diffuse in nature and its clear localization means that the situation is becoming threatening.

If we try to summarize the available information, then signs of appendicitis during pregnancy can manifest themselves in the forms described below.

According to average body measurements, the cecum may be located on the right, between the hypochondrium and the pelvis. In this case, its individual location is possible - it can be shifted towards the liver or bladder. In this regard, additional symptoms may be added to the pain resulting from appendicitis developing during pregnancy, the symptoms of which are noticeable. When the appendix is located above or below, this causes nausea, even vomiting, discomfort in the stomach or sensations like inflammation of the genitourinary organs. In this case, the pain may radiate to the kidney area, the inguinal fold on the right, or the right thigh.
There were cases of the onset of inflammation, which made itself felt by pain on the left, gastric colic, and only as the disease progressed did the painful area shift down to the right.
You can expect a standard location of the pain area if the period is short, and as the fetus grows, it will be located higher and higher: at the level of the solar plexus or closer to the ribs.

It should be remembered that this is not necessarily appendicitis; symptoms during pregnancy, especially in the last trimester, can occur for various reasons, for example, quite severe pain appears with increased gas formation. Such probabilities further complicate the diagnosis of appendicitis in pregnant women.

Signs of appendicitis

However, you should know the characteristic symptoms of appendicitis in pregnant women, which occurs precisely as a result of inflammation of this small appendix:

the pain continues to increase, the condition quickly worsens, the nature of the pain is colicky;
when moving, when trying to lie on the right side, the pain becomes stronger, but if you lie on your back and pull your legs towards your stomach, it weakens;
when trying to determine the development of appendicitis by pressing on the abdomen and abruptly releasing it, you may not get results; in pregnant women, the expected pain does not always occur, even in the case of developing inflammation;
the appearance of weakness, even fainting;
an increase in temperature is possible, and the thermometer will show different values in the rectum and armpit;
Nausea and vomiting may occur, but this symptom is more often interpreted as toxicosis, especially if the period is short;
A complete blood count will reveal the presence of an increased number of red blood cells.

Since all signs of appendicitis in pregnant women, even with intense manifestations, are not specific, an examination will be prescribed.

Diagnosis of appendicitis

An accurate diagnosis can be made immediately only through examination using laparoscopy. Through a small puncture, a probe with a sensor is inserted into the suspected area of localization of the cecum to see its condition. If there are signs of developing inflammation, the appendix is immediately removed. However, this method is not available in all clinics.

Examination by laparoscopy

If there is no appropriate equipment, then if there is suspicion, the woman is placed in a hospital, where her condition is monitored. If there is a noticeable deterioration, the diagnosis is confirmed. In addition, a urine test is performed. Considering that the symptoms of appendicitis in women during pregnancy and signs of inflammatory diseases of the genitourinary system are similar, the absence of leukocytes in the urine may indicate appendicitis, their presence is a sign of bladder or kidney disease.

Ultrasound is also used to determine the condition of the cecum, but in some cases it is ineffective.

If classical methods fail to confidently determine the presence of pathology, the woman remains under medical supervision. In this case, you should not take painkillers so that the picture of the condition is clear and the signs of appendicitis in a pregnant woman enable doctors to analyze and take measures in accordance with them.

Is it possible to have surgery?

Treatment of an inflamed caecum can only be surgical, and this should not be postponed under any circumstances, since this disease poses a serious threat to life.

Removal of the appendix in the usual surgical way is performed under anesthesia, the patient is prescribed antibiotics that will cause minimal harm to the mother and child. This is necessary to prevent inflammation after surgery, as well as to prevent infection of the fetus.

Therapy during the recovery period includes vitamins and medications that help normalize blood flow and good intestinal function. Medications are also recommended to maintain the tone of the uterine muscles and prevent cramps. Bed rest is usually prescribed.

The expectant mother who had to undergo surgery will be under the supervision of a doctor until the end of the pregnancy, since there is a risk of premature birth.

If the surgical intervention was carried out in the last weeks of gestation, then enhanced monitoring of the condition of the expectant mother and fetus is carried out, as well as particularly careful monitoring of the birth process. This is explained by the fact that when pushing, the surgical sutures may come apart.

The danger of inflammation of the appendix

Such a pathology occurs quite often during pregnancy; about 5% of women at different stages face this problem. Therefore, there is no need to be afraid, the main thing is to seek help if pain occurs.

Under no circumstances should you self-medicate, take painkillers, or postpone a visit to the clinic. The occurrence of colicky or nagging pain can mean incipient appendicitis during pregnancy, the consequences for the child can be tragic. Therefore, it is better to play it safe.

There is some risk of exposure to medications that a woman will have to take before and after surgery, but the risk of using these medications is much lower than the consequences of peritonitis, which will begin if the inflamed appendix is not removed in time. In this case, the woman may die.

Therefore, if the doctor is not sure that the cause of the pain lies elsewhere, he has to decide on his own responsibility whether to prescribe an operation.

A particularly dangerous situation arises if a pregnant woman experiences acute appendicitis, in which case the lack of emergency measures within a short time can even lead to death.

However, an uncomplicated form of appendicitis occurs more often, in more than half of women. At the end of the period of bearing a child, the risk of developing pathology is higher; inflammation can take a severe form, for example, phlegmonous, which will turn into peritonitis.

The degree of risk differs at different periods, but there are sad statistics:

in an uncomplicated form, spontaneous abortion or unsuccessful birth occurs in 15% of cases;
the transition of appendicitis to peritonitis, in 30% of cases ends in fetal death. This is a consequence of the general condition of the woman with the development of peritonitis, in which normal interaction with the fetus and its supply of oxygen becomes impossible.

Possible complications that may arise at any time:

loss of a child;
early delivery;
various complications after surgery;
acute intestinal obstruction;
dysfunction of the uterine muscles;
lack of oxygen in the blood, which can lead to fetal hypoxia;
Bleeding may appear after childbirth.

The highest risk of negative consequences occurs in the first few days after surgery.

Conclusion

If you experience pain, weakness, or nausea, you should not attribute everything to toxicosis. At an early stage, signs of appendicitis may be similar to the usual minor ailments of a pregnant woman, so it is better to check with your doctor.

Methodologically, removing the appendix of the cecum is not a complicated process, but there are a lot of accompanying factors that make it difficult for doctors to perform surgical intervention in the body. This complicating factor is, especially in the later stages, because not a single doctor can guarantee the safety of the expectant mother and her baby. Appendicitis during pregnancy becomes a real challenge of fate, which must be dealt with in time by both the pregnant mother and her attending physician.

Causes of inflammation

In most cases, the cause of inflammation of the appendix is the same: it is an acute reaction to the abundant development of intestinal microflora in the appendix. Since it consists of a large number of lymph nodes, with the slightest increase in the titer of bacteria, the body instantly reacts to changes in microbiological parameters with an inflammatory process.

Inflammation is mainly caused by mixed infection of several groups of anaerobic bacteria (streptococci, staphylococci, diplococci, E. coli).

Pregnancy is not an indication for the occurrence of pathology, however, among pregnant women there is a direct tendency to develop it. This is facilitated by a global restructuring of the expectant mother’s body, as a result of which increased peristalsis of the appendix, its bending, and stagnation of feces are often observed, which is typical when a healthy state is disturbed. In this state, ideal conditions for dangerous microflora are created in the intestinal tract.

Did you know?More than a hundred years ago, many children had their appendix forcibly removed, which helped to avoid serious consequences in the future.

Often, removal of the appendix during pregnancy is facilitated by its blockage with fecal stones or a foreign body of organic and inorganic origin (or other fruit pits, seed husks, accidentally swallowed artificial objects). In this case, abundant mucous masses accumulate in the intestines, which cause additional pressure on the intestinal walls.

The cause of acute appendicitis in pregnant women can also be a malnutrition of the expectant mother. Excessive consumption of food rich in animal protein creates ideal conditions in the body for the rapid proliferation of harmful bacteria.

Symptoms

Due to the special functioning of the body in pregnant women, the symptoms of the disease are somewhat different from standard indicators. This is due to the displacement of the process of the cecum itself when the abdominal wall is stretched. As a result, it is important to highlight the characteristic symptoms of inflammation against the general background of the unfavorable state of health of the expectant mother. These primarily include:

nausea and vomiting, which are skillfully disguised behind the characteristic position of a woman;
in the abdomen, localized in the first in the right iliac region. In later periods, they can be localized much higher than the appendix and even lead to unpleasant sensations in the spine;
shortness of breath and noticeable general difficulty breathing;
severe tension and bloating, which increases with simple palpation;
the patient’s general body temperature increased to 37–38 degrees;
cardiopalmus;
thick whitish coating on the tongue;
impaired urination (a rare symptom, but when it appears, a woman should pay attention to her own well-being especially scrupulously).

Important! The location of the process of the cecum during the growth of the abdomen can significantly influence the symptoms and course of the disease. For example, if the appendix is located near the liver, then when it becomes inflamed, symptoms characteristic of gastritis will appear; if the appendix is located near the urinary system, a woman may feel aching pain in her legs.

Effect on the fetus

If signs of appendicitis occur in a woman during pregnancy, the next important question for the expectant mother is how this condition will affect the child. It is not possible to say that the disease will not affect the baby. Starting from the second trimester, the inflammatory process in the intestines can lead to loss, but most of all, the threat of miscarriage is real only from the third trimester.

There are cases when the disease can provoke the most terrible pathology - placental abruption. During this process, the connective tissue, also known as the placenta, is prematurely separated from the walls, resulting in the loss of the natural functioning of this organ.
This violation directly threatens the life of the child. This phenomenon is most dangerous after the 20th week of pregnancy, since during this period the possibility of tissue self-healing is lost. Fetal mortality in this case is 1 case out of 6.

Also, with inflammation of parts of the cecum, infection of the membranes of the reproductive organs is possible, as a result of which the child becomes infected with pathogenic microflora, which entails an additional load of antibacterial drugs. This phenomenon mostly occurs after surgical removal of appendicitis and requires mandatory restorative therapy.

Diagnosing the pathology of the cecum is quite difficult. As mentioned above, the special state of the female body during pregnancy can mislead even an experienced doctor. Doctors suspect such a pathology even when the patient complains of pain in the abdomen and its surroundings even at rest, especially when they are accompanied by elevated body temperature. In this case, palpation of the abdomen is performed. If, when pressed, the pain intensifies or radiates to the surrounding area, the doctor shows additional suspicion of a malfunction of the appendix.
The next step is urine. A sign of pathology is an increased content of leukocytes under microscopy, this indicates a strong inflammatory process in the body. However, this analysis is not indicative, since leukocytes in the urine increase due to any inflammation or infection, which is why such an analysis will not be enough.

The most modern way to diagnose pathology is ultrasound. Using the device, the diagnostician can easily determine changes in the size and thickness of the appendix, including diagnosing an abscess. However, ultrasound gives the expected result only in half of the cases, since the equipment can only see the process of the cecum in half of the patients.
One of the most accurate methods of laboratory and instrumental control is laparoscopy. Only with its help can a diagnostician determine the condition of the abdominal organs and their pathologies. During the procedure, a special camera is inserted into the body, which on the doctor’s monitor shows everything that is happening inside. Laparoscopy is today the only method that most accurately determines inflammation in the abdominal cavity.

Is it possible to have it cut during pregnancy?

This is one of the most discussed issues in almost all medical forums. No expectant mother wants problems with appendicitis during pregnancy to have consequences for the child. It is not only possible, but also necessary to cut out an inflamed appendix for a pregnant woman. Currently, there are no other therapeutic methods for treating this pathology. You should not be afraid of removal, as it is simple and safe, the side effects of which are kept to a minimum. But a delay in removal can negatively affect the health of the mother and her baby. A constant inflammatory process can become chronic and involve other organs and systems, even leading to miscarriage even in the later stages. Secretions with a high titer of pathogenic bacteria accumulated in the appendix can lead to infection of the fetus, which can also jeopardize the entire pregnancy.

Treatment methods

We have figured out how to determine appendicitis during pregnancy, followed by understanding the basic methods of eliminating the disease. As mentioned above, it is impossible to cure an inflamed appendix; this kind of pathology involves its complete removal through surgical intervention in the body. At this stage, you should determine how this can and should be done.

Did you know?The appendix is the property of exclusively herbivorous organisms. But, despite this, humans are still classified as representatives of predators.

Standard operation

With this type of surgical intervention, an incision about 10 cm long is made near the object to be removed, through which the doctor removes the inflamed appendix, after which several stitches are applied. Next, in case of an abscess, a drainage system is applied to the fresh wound. Using rubber drainage tubes, the problem area is dried. If the course of rehabilitation is favorable, doctors can remove the sutures from the incision within 7–10 days after the operation.
This type of surgery is standard in most cases, but it has one significant cosmetic drawback - a noticeable lifelong scar in the lower abdomen. As the most cosmetically beneficial option, laparoscopic surgery has been gaining popularity in recent years.

During laparoscopy, the patient, just as in the first case, receives high-quality medical care, but gross penetration into the body does not occur. With this type of manipulation, one or several small holes are made on the patient’s body, through which, using special instruments, the doctor examines and removes the problem area of the intestine in the abdominal cavity.
This procedure is virtually painless and does not require a huge amount of painkillers. The main disadvantage of laparoscopy is the rather expensive medical equipment, which is not available in all medical institutions.

Postoperative rehabilitation

After the appendix is removed, it is time for rehabilitation. During this period, the pregnant woman is under constant medical supervision, as there is a high probability of severe complications. Doctors choose a gentle path of rehabilitation, in which standard means and drugs are replaced with softer ones. In this case, it is possible to minimize the negative impact of treatment on the fetus.

Specialists also carry out the prevention of premature and general termination of pregnancy. The expectant mother is advised to remain in bed, normalize her diet and give up all unhealthy food, and take a general course of vitamins for young mothers. Doctors often prescribe other antispasmodic substances.

With a normal course of rehabilitation, already 2-3 weeks after the operation, the expectant mother can safely return to her previous life.

How does childbirth go?

In most cases, after removal of the appendix, they go well, especially if the operation was performed 1.5 months or even earlier. But a woman in labor automatically becomes the object of additional attention from doctors. The fetus and the course of its development are subject to maximum control. In case of pathological changes, the pregnant woman is immediately sent to the hospital.
When childbirth occurs just a few days after the operation, it is carried out as carefully as possible, monitoring the condition of the fresh wound and the integrity of the sutures. Prevention is also carried out to eliminate the lack of oxygen in the child and shorten the period of expulsion of the fetus. as this reduces the risk of tearing of the applied seams.

Important! If the birth is favorable, control over the woman’s condition cannot be reduced; at this time, it is important to prevent serious complications for the body, such as bleeding or other pathologies.

Even if you did have to undergo appendicitis removal during pregnancy, you should not worry about the life of the child, since monitoring the well-being of the birth will be under the clear and scrupulous supervision of doctors. In this case, it is necessary to think about the moral attitude towards a positive result, since stress itself can become a side effect of the operation.

Many pregnant women associate abdominal pain with their position, which often turns out to be true. But it is pregnancy that can trigger an attack of appendicitis. To ensure that an attack does not take you by surprise, you should clearly know how this disease manifests itself, what its symptoms are, and how to deal with it.

Appendicitis is an inflammation of the appendix. It is worth noting that there are quite a few pregnant women with this disease (about 3.5%). Acute appendicitis in pregnant women is somewhat more common than in other representatives of the fair sex.

The reasons for the development of this disease are still not precisely known to scientists. One version is blockage of the lumen that exists between the appendix and the cecum. As a result of the blockage, the blood supply to the appendix is disrupted, which leads to swelling and the development of the inflammatory process.

Often pregnancy is a factor predisposing to the manifestation of this disease. This is caused by the growth of the uterus, which, by squeezing the appendix, disrupts its blood supply and, accordingly, leads to inflammation.

In medicine, it is customary to distinguish between two forms of appendicitis: catarrhal and destructive. Each of these forms requires a certain time for the development of the disease. The catarrhal form of the disease develops within 6-12 hours, destructive forms can develop a little longer from 12 hours to two days, then perforation may occur, that is, the contents of the intestine can enter the abdominal cavity.

It is impossible to name specific symptoms of appendicitis in pregnant women, because each woman’s body is individual, so changes in the appendix can occur in different ways, in addition, not everyone’s appendix is located in the same way.

When inflammation occurs in the appendix itself, without affecting the abdominal cavity, a woman, as a rule, bothered by pain in the upper abdomen, which gradually move into the lower right part of the abdominal cavity. Symptoms of appendicitis may include: vomiting, upset stomach, nausea .

Sometimes the pain is minor and occurs in all areas of the abdominal cavity. When examined by a doctor, pain may not be immediately detected and may be detected in the area above the uterus. Also, pregnant women often experience pain when lying on their right side, when the uterus puts maximum pressure on the inflamed appendage.

With the development of the inflammatory process, pain begins to appear in the right iliac region. Often, painful sensations spread to the lower and upper parts of the abdominal cavity and even to the hypochondrium. The degree of pain, as a rule, depends on the duration of pregnancy, that is, the more the uterus puts pressure on the inflamed appendix, the stronger the pain.

It is worth noting that all the symptoms that are characteristic of patients with appendicitis may be less pronounced in pregnant women or appear somewhat later.

It is worth noting that pain during inflammation of appendicitis can also be influenced by the nature of the location of the appendix: if the appendix is located under the liver, then a pregnant woman may experience symptoms that are similar to those of gastritis: pain in the upper abdomen, nausea and even vomiting.

When the appendix is located low, when it borders the urinary system, pain can radiate to the legs, perineum, the woman may experience a frequent urge to urinate, which is why it is important not to confuse inflammation of the appendix with cystitis in this case.

How does appendicitis affect the fetus?

Of course, the development of the disease in the second trimester of pregnancy has an impact on the unborn baby. The most common complication is the threat of late pregnancy termination. Complications also include infections that may occur during the postoperative period and intestinal obstruction.

Rarely, but still there are cases when pregnant women with an appendix may experience premature placental abruption. In case of timely diagnosis of detachment and proper treatment, pregnancy can be maintained and brought to an end. In the case of inflammation of the membranes, intrauterine infection of the baby occurs, and mandatory antibacterial therapy is required.

Complications usually occur during the first week after surgery to remove the appendix. Antibacterial therapy is recommended for all pregnant women as prophylaxis in the postoperative period.

Diagnosis of appendicitis in pregnant women

A doctor must diagnose this disease. As a rule, the presence of appendicitis in a pregnant woman can be indicated by high body temperature, pain (sometimes quite severe) in the right side of the abdomen when walking or even at rest. Often, upon palpation, the pain intensifies with gentle pressure on the abdomen, and then when the doctor’s hand is withdrawn.

The disease can also be diagnosed according to urine analysis(an increase in leukocytes may indicate the presence of appendicitis). It is worth noting that an increase in white blood cells can be caused by any inflammatory process or infection occurring in a pregnant woman, which is why a urine test is not enough to make a diagnosis.

One of the most modern and reliable methods for determining appendicitis in pregnant women is ultrasonography, which allows you to see an increase in the process and even an abscess. But it is worth noting that with ultrasound, only half of the patients can see the appendix, which will allow the doctor to give an accurate conclusion about the inflammatory process.

Another diagnostic method is laparoscopy. During this procedure, the doctor can see all the abdominal organs, including the appendix. If appendicitis is detected, it should be eliminated immediately. Laparoscopy is the most accurate method that allows you to reliably determine the presence of an inflammatory process in the abdominal cavity.

That is why, if a pregnant woman is suspected of having inflammation of appendicitis, she should go to a hospital, where they will organize constant monitoring, do the necessary tests and diagnostics, and, if necessary, perform an operation to remove the inflamed appendix.

How is appendicitis removed?

Unfortunately, once this diagnosis is made, treatment is only possible through surgery. Now surgery to remove appendicitis in a pregnant woman can be performed both traditionally and with the help of special punctures in the abdominal cavity.

At standard operation A skin incision is made over the area where the appendix is located. The length of the cut is about 10 cm.

The surgeon examines the appendix and the abdominal cavity around it to rule out the presence of other abdominal diseases. The appendix is then removed, and if there is an abscess, it is dried using drains that are brought out. Then sutures are placed on the incision, which are removed, in a normal postoperative period, after a week.

A new way to remove appendicitis in pregnant women is to use an optical system. At laparoscopy The doctor may perform surgery to remove the appendage through small holes in the abdomen instead of a large incision. The advantages of this method of treatment are undeniable: postoperative pain is reduced and recovery occurs much faster.

In addition, laparoscopy provides an excellent cosmetic effect, which is an important factor for most women. Laparoscopy allows you to most accurately make a diagnosis when the doctor doubts the presence of an appendix in a pregnant woman. The laparoscopic method of removing appendicitis is the most optimal method of treating appendicitis in women expecting a baby.

How is the postoperative period after removal of appendicitis in pregnant women?

The postoperative period in pregnant women requires the attention of specialists, as well as the prevention of complications and certain therapy. After the operation, pregnant women do not have ice applied to their stomach, so as not to harm the course of pregnancy; a special gentle regimen is formed so that the pregnant woman can recover faster, and the removal of the appendix does not affect the health of her unborn baby.

There are also special products for pregnant women that help normalize intestinal function as soon as possible.

The use of antibiotics in the postoperative period is a necessary measure, but it is worth noting that the drugs are carefully selected by specialists, taking into account the woman’s condition and the duration of her pregnancy.

Prevention of premature birth and termination of pregnancy is also carried out, so the patient is recommended to stay in bed, eat right, take vitamins and follow all the recommendations of the doctor treating her. Special treatment is often prescribed to support pregnancy, including sedatives.

After discharge from the hospital, the pregnant woman is automatically included in the list of women at risk of miscarriage and early birth.

The fetus in pregnant women who have undergone surgery to remove appendicitis is also subject to careful study and monitoring. Doctors carefully monitor its development and monitor the condition of the placenta. In case of any disturbances in the development of the fetus or deterioration of the pregnant woman’s condition, she is sent to a hospital for appropriate treatment.

If childbirth occurs a few days after surgery to remove appendicitis, then it is carried out with special care and under special supervision. Make sure that the stitches do not come apart and provide complete anesthesia.

During the birth process, constant prevention of intrauterine oxygen deficiency is carried out for the child. The period of expulsion of the fetus is shortened by cutting the perineum so that the sutures placed during the operation do not come apart.

No matter how much time passes after the surgical intervention before delivery, childbirth in any case will take place under the vigilant supervision of specialists in order to exclude the occurrence of complications, postpartum hemorrhage and other anomalies.

In any case, even if you had to undergo surgery to remove appendicitis during pregnancy, you should not worry about the health of the baby. Remember that the emotional state of the mother is very important for your unborn child, and for the rest you should completely rely on the staff who will deliver the birth.

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Appendicitis is the most common reason for surgery during pregnancy. Among pregnant women, 2-5% of women develop appendicitis. A predisposing factor is an increase in the volume of the uterus, which can cause displacement of the appendix and disruption of its blood supply. And this, in turn, leads to inflammatory processes. There are other reasons for the development of appendicitis during pregnancy: a tendency to, displacement of the cecum, disruptions in the immune system, which leads to changes in the properties of the blood. Nutrition and abnormal location of the appendix in the abdominal cavity play an important role.

Diagnosis of the disease includes a blood test, urine microscopy, and ultrasound. But only with the help of laparoscopy can appendicitis be diagnosed for sure. In any case, it all starts with an examination and interview of the woman.

The main symptoms of appendicitis during pregnancy

How to recognize appendicitis? Symptoms of inflammation in pregnant women are the same as in everyone else. In patients, it often increases, and the indicators in the armpit and in the rectum can differ greatly. An essential symptom is a sudden onset of colicky pain, usually localized in the right iliac region. But in the later stages of localization, the pain may shift higher. During an acute attack, the patient remains for a long time in a forced position on her back with her legs brought to her stomach, breathing is shallow and rapid. Pulse rate, vomiting, bloating, and shortness of breath should also be taken into account. A complete blood count shows an increase in the number of red blood cells.

The longer the period, the more difficulties may arise during diagnosis, surgery and postoperative rehabilitation. Therefore, it is very important to make a diagnosis on time. Pregnancy itself complicates the recognition of inflammation of appendicitis, especially in the second half. Many symptoms are considered normal during pregnancy.

Regardless of the duration, inflammation of appendicitis is resolved exclusively by surgery. And the sooner this is done, the lower the risks for mother and child. Therefore, if you experience characteristic or simply suspicious abdominal pain, you should immediately consult a doctor. Self-medication for false causes delays the correct diagnosis and is extremely dangerous.

The development of appendicitis may pose a threat of termination of pregnancy, but is in no way an indication for this (regardless of the stage of pregnancy and the form of appendicitis). Caesarean section is resorted to only in exceptional cases. The need for cleaning may also arise in case of too large, when this interferes with the operation.

In addition to the threat of miscarriage, appendicitis during pregnancy threatens a number of other complications:

postoperative infectious processes;
intestinal obstruction;
in rare cases - premature placental abruption;
abnormalities of uterine contractility;
fetal hypoxia;
bleeding in the afterbirth period.

In the first postoperative days, the likelihood of complications is very high. Therefore, a number of features are taken into account. After surgery, do not apply weights or ice to the abdomen (this can cause pregnancy complications). Patients are prescribed drugs that relax the muscles of the uterus, and antibiotics to prevent infectious complications. Measures are being taken to maintain pregnancy, as well as improve bowel function. Pregnant women are prescribed long-term bed rest and sedatives. After discharge from the hospital, such women are included in the risk group for the threat of early termination of pregnancy. The condition and development of the fetus (which is believed to have suffered an intrauterine infection) is closely monitored. If childbirth occurs within a few days after the operation, it is taken very carefully and carefully: the abdomen is tightly bandaged, full anesthesia is used with extensive use of antispasmodics, and intrauterine prophylaxis is carried out.