How appendicitis manifests itself during pregnancy and how to distinguish its first manifestations in the early and late stages: symptoms, clinic, treatment and surgery. Signs of appendicitis during early and late pregnancy. appendicitis during pregnancy

Pregnancy is a wonderful time in a woman's life, associated with the expectation of the upcoming joy. Future mom can enjoy his interesting position and not allow thoughts of 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 referred to as the appendix. This process 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.

With the appearance of pain discomfort, many begin to remember which side the appendicitis is on. This should be known to everyone without exception, because it is impossible to delay 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 position. With severe pain in the abdomen, you should not postpone a visit to the doctor. Even if such a symptom does not indicate inflammation of the appendix, you should not leave it unattended.

Types of appendicitis during pregnancy

There are two forms of this disease: catarrhal and destructive. In the first case, the rudiment increases in size, puffiness appears, but the purulent contents do not flow out. The destructive variant of the pathology can be divided into several conditional 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 women in position. There is a reasonable explanation for this.

As the fetus grows and develops, the uterus increases in size, resulting in a displacement of the appendix. This anomaly causes circulatory disorders in the appendix and leads to an 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 caecum.
Vasospasm.
Infectious processes in the body of a pregnant woman.

If we systematize the etiology of the disease, in its history the leading role belongs to irrational nutrition and the wrong location of the appendix in the peritoneum. The most susceptible to the occurrence of appendicitis are people who are accustomed to eating dry food, abusing 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 pathology:

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

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

The pain syndrome is characterized by a colicky character, 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 tolerated on the legs, which often confuses the doctor when making a diagnosis.

Associated symptoms include the following:

Vomiting and nausea.
Signs of depression.
Chair disorder.
Increased fatigue.
Noticeable decline in performance.

It is important to understand that acute appendicitis and pregnancy is 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 the ailment accompanies, so that when it occurs, you do not waste precious time.

How does appendicitis affect the fetus?

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

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

Appendicitis during pregnancy: the consequences of the disease

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

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

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

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

Diagnostic measures

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

I was diagnosed with appendicitis during pregnancy. What to do?

The only one effective method elimination of inflammation - surgical intervention. It is impossible to reduce the manifestation of pathology even with medications. The operation is usually performed using a general variant of anesthesia. In some cases, epidural anesthesia may be used. It implies anesthesia of the legs and directly the area of surgical intervention.

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

Laparoscopic surgery is considered minimally invasive, so it is used most often. During the procedure, the surgeon abdominal cavity makes a small puncture, 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 for the corresponding surgical procedures are inserted.

Removing the appendix is quick and painless. After laparoscopy, a few small scars remain on the body, which completely disappear with time. This procedure is rarely used. The thing is that not all medical institutions have the necessary equipment and devices for its implementation.

The traditional operation is an appendectomy. During the procedure, the doctor makes an incision on the abdominal wall about 8 cm. After detecting the inflamed appendix, it is removed and the cavity is assessed for the presence of an abscess. If a pathology is detected, the doctor dries it with special drainage tubes, which are necessarily brought out. After that, the incision is sutured. On the seventh day, the stitches are removed.

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

Many women are concerned about the question of whether it is dangerous to conceive after appendicitis. According to doctors, if the inflamed process was removed by appendectomy, you can think about replenishment in the family after six months. Pregnancy after laparoscopy is safe after 2 months.

Postoperative rehabilitation

The postoperative period in pregnant women requires heightened attention doctors, prevention of possible complications. After surgery, women do not put ice on the stomach, so as not to harm the fetus. Usually, doctors recommend a special sparing regimen for a quick recovery.

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

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

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

If childbirth occurs a few days after the operation, they are carried out under special control. Doctors constantly monitor that the seams do not disperse. In the process of delivery, special attention is paid to the prevention of intrauterine hypoxia. Doctors, as a rule, reduce the time of the procedure itself by dissecting 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. Timely access to a doctor and a well-performed operation is the key to a positive outcome.
If pain discomfort occurs in the abdomen, which is accompanied by fever and vomiting, it is necessary to call a team of medical workers without delay.
Is the appendix removed during pregnancy? Yes, the only true treatment option for pathology is surgical intervention.
After the operation, a period of rehabilitation begins. At this time, the woman is shown bed rest, antibiotic therapy.

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

Appendicitis is a disease in which the appendix becomes inflamed (this is the name of the process of the caecum). For a long time, even medical science did not understand the significance of the appendix for humans, but now scientists have come to the conclusion that thanks to this organ, the intestinal microflora returns to normal after illnesses.

But the inflamed appendix requires surgical intervention to remove it. But what if a woman in position faces this ailment? How is appendicitis diagnosed and treated during pregnancy?

Causes of inflammation of the appendix during pregnancy

Pregnancy in a woman's life is a period that, in addition to joyful moments, is also associated with many difficulties. If the stomach suddenly gets sick, this is usually associated with the condition of the fetus. It rarely occurs to anyone that these could be disturbances in the functioning of the woman's body, and even more so, it is unlikely that anyone will remember the possibility of inflammation of the appendix. And, in general, is there appendicitis in pregnant women?

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Unfortunately, it still happens. Moreover, a pregnant girl has a higher risk of inflammation of the appendix than one who does not yet carry a baby under her heart. Most likely, the main reason for this situation is that the uterus, increasing, compresses and displaces the internal organs. As a result, blood flow is disturbed in the compressed appendix and its inflammation is observed.

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Appendicitis is a common abdominal disease in which the appendix becomes inflamed (worm-like…

Another possible explanation for appendicitis in expectant mothers is the intense production of the hormone progesterone, which has a relaxing effect on the muscles of the peritoneal organs, and the organs of the digestive tract are no exception. As a result, there is a delay in food, constipation appears, the feces become hard. Its slow progress through the large intestine can provoke the entry of feces into the appendix. As a result, it becomes clogged. In inflammatory processes in the body lies a great danger. It is absolutely impossible to ignore them.

Typical signs of appendicitis during pregnancy

Manifestations of appendicitis during pregnancy are different from the typical signs of this disease. Symptoms of appendicitis in women during pregnancy, such as nausea and vomiting, do not always appear. As a rule, appendicitis in pregnant women signals itself with painful sensations on the right side of the abdomen. The location of the pain and its severity at different stages of pregnancy may change.

In the first trimester, the pain is most noticeable in the navel, after it moves to the right. With any tension in the abdomen, for example, coughing, pain becomes more intense.

As the pregnancy progresses, as the uterus enlarges, it moves the appendix back a little. IN this case symptoms in pregnant women of appendicitis are manifested by pain in the liver area.

In the last trimester, the pain is felt under the ribs, it seems that behind the uterus, sometimes it moves to the lower back, closer to its right side.

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Since a pregnant woman already feels heaviness in her stomach, it is not easy to determine the presence of appendicitis, but there are methods that will help to do this exactly:

If you roll over from the left side to the right, then the pain becomes stronger (Tatarenko's symptom).
The pain increases when lying on the right side because the uterus presses on the inflamed area (Michelson's symptom).
Dull, persistent pain on the right side, accompanied by nausea, vomiting and diarrhea.

If the appendix is near the bladder, symptoms of cystitis may appear: frequent urination, pain in the perineum.

If the appendix has already ruptured and peritonitis has developed, then this is accompanied by the following symptoms:

body temperature rises;
pulse quickens;
shortness of breath appears;
belly bulges.

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Diagnosis of appendicitis in pregnant women

It is very difficult to diagnose appendicitis in pregnant women, due to the natural physiological changes in a woman's body associated with her position. Features of the course of the disease of acute appendicitis in pregnant women have an individual character.

As a rule, fecal stones that get stuck when the appendix passes into the caecum can be detected during an X-ray examination. But for a girl in position, such a procedure is unacceptable, especially at the beginning of pregnancy, when the organs of the fetus are just being formed. X-ray exposure can contribute to the formation of pathologies in a child.

An ultrasound examination for possible appendicitis is done, but only to determine if there are other diseases of the internal organs that can give symptoms resembling inflammation of the appendix. An ultrasound scan to determine this ailment in pregnant women cannot provide the necessary information. Since the process is pushed inward, it simply cannot be examined using ultrasound.

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One of the mandatory procedures in such a situation is a complete blood count. If there is an inflammatory process, then the number of leukocytes in the blood increases.

But the main way by which the diagnosis of appendicitis in a pregnant woman is confirmed is a medical examination. The doctor finds out how severe the pain is, how it changes with walking, tension in the abdomen, how high the body temperature was, and whether nausea, vomiting, and diarrhea are noted.

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Treatment of the appendix during pregnancy

Since appendicitis in pregnant women does not have pronounced symptoms, most often women come for a consultation with a doctor when the inflammatory process is already strongly running.

It is possible to cure inflammation of the appendix during pregnancy with only one method (in fact, as in a non-pregnant woman) - by performing an operation to remove it. Removal of appendicitis in a girl during pregnancy can be performed either laparotomically, by making a small incision above the appendix, or laparoscopically, using 3 abdominal punctures.

For the treatment of pregnant women, the laparoscopic method is usually used. The operation of removing the appendix through small holes is performed under general anesthesia. In the last weeks of pregnancy, it is possible to carry out an emergency caesarean section.

After the operation to remove the appendix, the pregnant woman should adhere to bed rest for 4-5 days and undergo regular examinations by a gynecologist. It is necessary to strictly follow the diet prescribed by the doctor. To prevent complications, the use of drugs and physiotherapy are prescribed.

It is important to remember that the sooner you seek medical help and start treatment for inflamed appendicitis in pregnant women, the higher the chances of a successful outcome for a woman and her child.

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Possible consequences of appendicitis during pregnancy

A responsible woman who cares about her health and the health of her baby should immediately seek help from a doctor if any pain occurs in the abdomen.

Appendicitis in girls during pregnancy is not a good thing. If you do not intervene in a timely manner in the process of inflammation of the appendix during pregnancy, then the consequences cannot be avoided. How can this threaten a woman and her child? Firstly, it is fetal hypoxia, that is, a lack of oxygen. May happen premature detachment placenta, which is tantamount to fetal death.

For the woman herself, a high opportunity:

the formation of intestinal obstruction;
large loss of blood;
peritonitis;
septic shock.

Appendicitis is the most common reason for emergency surgery during pregnancy. Most cases of inflammation in this anatomical segment occur in the second trimester, when they are difficult to diagnose both clinically and by imaging. Even though it hurts Right side abdomen during gestation may different reasons, paying attention to the symptoms of appendicitis in pregnant women is very important, since a rupture of the process of the cecum threatens the death of the mother and child.

Its removal does not affect human health, but current research is exploring the possibility that this anatomical structure can protect the colon from attack by pathogens, therefore beneficially affecting its function, leaving it healthy. The most common form of treatment for appendicitis is surgery, which involves the removal of the appendix in various surgical ways.

The vestigial organ becomes infected as it begins to grow - it becomes inflamed, pus accumulates, the body's immune system tries to contain the spread of the infection. Appendicitis during pregnancy develops certain signs, duration, nature, intensity of which is predetermined by the period of intrauterine stay of the fetus. In the first trimester, they include:

Vague dull pains in the upper abdomen or around the navel, disturbing for several hours or days, then moving to the lower right side of the abdominal cavity.
Worsening of pain when moving, coughing or laughing, since the tension of the abdominal muscles in this case affects the inflamed appendix.
Loss of appetite develops - it is found that the last few days before the onset of signs of appendicitis are characterized by a lack of interest in food, which is extremely unusual for pregnant women.
When the pain intensifies, a feeling of malaise, weakness, and fatigue increases.
Digestive disorders - not being able to fully defecate - a characteristic phenomenon for the onset of appendicitis; an accumulation of intestinal gases develops, forming a concomitant pathological condition - flatulence.
Vaginal bleeding. If it is accompanied by intense spasms, the lower abdomen begins to hurt.
Nausea occurs up to several times a day, accompanied by chills, weakness, a woman may even experience dehydration if the attacks constantly end with vomiting.
Fever, followed by the development of hyperthermic syndrome.
Edema. This sign is difficult to identify on the general background of pregnancy.

In the second and third trimester (from the 13th to the 40th week of pregnancy)

Symptoms of appendicitis in pregnant women in the 2nd and 3rd trimester are mostly the same as in the first, except that due to the growth of the uterus, the pain spreads to the middle or upper right side of the abdomen. Vaginal bleeding is more intense, which is often confused with the clinical picture of placental abruption or interrupted pregnancy.

Since pregnancy and acute appendicitis are mutually exclusive conditions, the main task of doctors is to ensure the well-being of mother and child. That is why it is important to diagnose inflammation of the appendage of the caecum as soon as possible. The delay often leads to the loss of the fetus, the risk increases many times for the condition of women arriving almost on the eve of childbirth.

We must not forget that due to changes in the body of a woman during pregnancy, the picture of acute appendicitis may be distorted.

Diagnostics

During pregnancy, diagnosing appendicitis is much more difficult. Displacement of the appendix towards the uterus, an increase in the thickness of the visceral and parietal part of the peritoneum reduces the ability to determine the localization of pain during physical examination. Uterine contractions and diffuse pain in the umbilical region migrates to the right lower quadrant of the abdominal cavity. Circumstances such as:

False contractions that occur in the same projection where the pregnant woman has an appendix.
Dyspeptic syndrome characteristic of normal pregnancy.
Data laboratory research, where changes in the qualitative and quantitative composition of the blood can be explained by changes in the body during the period of bearing a child.

Physiological changes that occur during pregnancy, such as leukocytosis (an increase in the number of white blood cells in the blood) and a reduced tendency to develop hypotension and tachycardia, may worsen the general condition. After perforation of the appendix occurs, the likelihood of fetal loss increases at least 3 times. Some symptoms of appendicitis during pregnancy, such as nausea and vomiting, resemble the manifestations of toxicosis characteristic of the period of bearing a child. Therefore, sometimes misleading, which is a danger.

Stages of development of appendicitis

Appendicitis during pregnancy has several stages of changes. The inflammatory process at first is considered catarrhal, but gradually turns into a purulent form:

phlegmous - acute inflammation that develops in a day;
gangenous - tissue necrosis. The form develops in two days;
perforative - the walls of the organ break through, the inflamed contents fall on healthy organs.

The first stage is the simplest - the onset of inflammation. There are symptoms by which the disease can be easily diagnosed.

Clinical picture

Signs of appendicitis in pregnant women have some specific course, in contrast to the usual form of inflammation. The main symptoms are as follows:

severe pain, having a cutting character, on the right in the abdomen;
heat;
nausea, accompanied by vomiting bile;
the pain syndrome becomes stronger if you try to feel the sore spot.

A sign that is detected only in the clinical diagnosis of appendicitis in pregnant women is a significantly increased level of leukocytes in the blood.

The danger lies in the fact that at the very beginning the pain syndrome is not strong, the pregnant woman simply does not pay attention to it. However, the pain increases significantly after 2-3 hours. At the very beginning, it is difficult to diagnose appendicitis - the entire abdominal cavity hurts, but gradually the pain intensifies on the right.

One of the causes of inflammation of the appendix is the enlarged uterus, due to which it is displaced from its place. In this regard, pain can manifest itself as discomfort in the right hypochondrium, in the side or in the lumbar region.

A feverish symptom is not a strict sign of inflammation of the appendix. The temperature rises 4-5 hours after the onset of pain, so it can be considered a symptom of appendicitis during pregnancy. If fever was before abdominal pain, then most likely it is a sign of another disease. In any case, you must go to the hospital.

The temperature rises as a natural reaction of the immune system, aimed at combating the inflammatory process. A sharp jump to high levels will indicate the progress of inflammation.

Vomiting and nausea in some cases appear to painful discomfort. In this case, they are quite easy to mistake for toxicosis characteristic of pregnant women or food poisoning. If these symptoms accompany severe and acute pain, then you should immediately seek medical help.

Appendicitis shows obvious signs in the last stages. A woman feels weak, cannot speak coherently, her consciousness becomes cloudy - this means that the inflammatory process is so strong that it can be fatal for both the pregnant woman and the child.

Diagnosis of appendicitis in pregnant women

Appendicitis in pregnant women is difficult to diagnose, but how quickly it is done has a strong influence. The sooner, the less likely the occurrence of acute consequences complicating the disease.

The primary examination includes an anamnesis. The doctor finds out from the pregnant woman when and how pain appeared, which symptoms manifested themselves more strongly.

The next step is a direct examination, which includes three signs for diagnosing appendicitis in pregnant women:

The surgeon presses on a certain part of the body on the right in the iliac region, after which he sharply draws his hand down - the pain syndrome intensifies during the inflammatory process.
Next, a light tapping is carried out throughout the abdomen, while the pain again intensifies.
The abdominal muscles located above the caecum and directly above the process are palpated.

It is not always these symptoms that are expressed in pregnant women in the diagnosis, but surgeons mainly rely on them.

Clinical studies are required to confirm the diagnosis. The following examinations are carried out: a general blood test to detect the level of leukocytes, as well as the rate of erythrocyte sedimentation. A urine test may also show an increase in white blood cells.

Additionally, an ultrasound is performed to detect an inflamed process in pregnant women. One of the demonstrative studies is laparoscopy, but this method is accompanied by surgical intervention, which is not always good for pregnant women.

Medical therapy

In the treatment of appendicitis, only one method is used - surgical. The method was called "appendectomy". In addition, in recent years, endoscopic surgery, performed by punctures and controlled from a monitor, has been gaining popularity.

Drug therapy is used - the patient is given antibiotics that will prevent the development possible consequences in the form of suppuration of wounds or sutures. Each time, antibiotics are selected individually so as not to harm the fetus and the health of the pregnant woman.

The traditional operation - "appendectomy" involves a thin incision of the skin and layers of abdominal muscle tissue directly under the area where the appendix is located. The incision should be no more than 10 cm and made with the utmost precision. The doctor examines the process of the caecum, surrounding organs and tissues for spreading suppuration or necrosis. Only after making sure that the tissues around are clean, the surgeon proceeds to remove the process - this part of the caecum is simply cut off. In the event that there is suppuration, drainage therapy and washing are carried out. The incision is then carefully sutured.

The latest technique for performing the operation is to use a laparoscope. Laparoscope - a system of optical fibers combined with a mini-camera. One small puncture of the abdominal cavity is enough, where the optical fiber is inserted. After determining the inflamed area, several more punctures are made through which instruments are inserted, and the process is removed directly in the abdomen.

The new method has a lot of advantages over the traditional one: less pain, recovery after surgery is much faster, no cosmetic defects. In addition, the surgeon may conduct a routine examination if the diagnosis of appendicitis has been questioned.

Laparoscopic surgical technique is considered the best for pregnant women, since the damage is minimal.

However, any operation is done under anesthesia. The dose must be clearly adjusted so as not to harm the child.

Recovery period

Pregnant women require careful monitoring after surgery. Preventive measures are being taken against possible complications, as well as their therapy.

After surgery, it is not planned to apply weights and cold compresses to the abdomen so as not to provoke pregnancy complications. A special diet is prescribed, most of the products from which are aimed at normalizing the functioning of the digestive tract and intestines.

A widely used method of physiotherapy aimed at improving bowel function. In addition, physiotherapy is necessary for the prevention and overall preservation of pregnancy.

Antibiotics are used to prevent possible postoperative complications. Drug therapy is selected individually for each woman in order to avoid the possible consequences of the influence of antibiotics on the growing fetus.

In preventive measures, it is recommended to lie much more, observing complete rest. This is easily achieved, since pregnant women spend the postoperative period in a hospital under the close supervision of doctors. Medicines are used to calm the fetus and prevent frequent uterine contractions.

A pregnant woman who has undergone an operation to remove the appendix is included in the risk group due to the possible termination of pregnancy. Prevention is aimed mainly at preserving the fetus, since the consequences can occur in the long term. The threat of miscarriage that has arisen is supervised by the attending physician until childbirth.

The developing fetus is subjected to a more thorough examination. The number of standard appointments at the gynecologist is increasing, all measures are being taken to monitor the development, the condition of the fetus, and also the integrity of the placenta. Conducted studies may be as follows: hormonal, dopplerometry, ultrasound.

One of the possible complications is fetoplacental insufficiency, which occurs when developing child does not receive enough oxygen and lacks nutrients. In this case, the pregnant woman is immediately hospitalized and necessary measures for the preservation of the fetus.

In the event that childbirth occurs a few days after the operation, the stomach is tightly bandaged. This avoids the divergence of the seams. At the same time, a full range of painkillers is also used to relieve pain, enhanced due to surgical intervention.

Due to the increase in pressure inside the abdominal cavity, the sutures may come apart. To prevent this, an incision is made in the perineum to speed up labor and relieve the effects of attempts.

Childbirth can always be complicated. There may be anomalies of birth forces, severe bleeding in the postpartum period. That is why increased measures are applied to control the course of childbirth in a woman in labor, who was operated on during the period of bearing a child.

Appendicitis is a very dangerous pathology for any person, and if it appears during pregnancy, you should immediately consult a doctor. Thus, a pregnant woman will be able to avoid serious consequences for herself and her child.

Appendicitis- This is a disease that is characterized by an inflammatory process of the appendix (appendix) of the caecum. This complication is extremely dangerous, especially on later dates pregnancy.

Appendicitis- one of the most common acute surgical diseases, the diagnosis of which is not difficult. Pregnant women still have difficulties with the diagnosis, since the manifestations of appendicitis are often superimposed on other changes in the body that accompany pregnancy - toxicosis, displacement of the intestines and internal organs, increased gas formation and general malaise.

In modern medicine, most doctors - a gynecologist and a surgeon - will be able to help such special patients as expectant mothers.

After reading this article, do not be afraid. In fact, acute appendicitis is rare among pregnant women (about 5% of cases). It is important to be especially vigilant and know the main symptoms in order to consult a doctor in time and prevent life-threatening complications.

Causes of appendicitis in pregnant women:

As a rule, appendicitis in pregnant women is most common at 35-38 weeks, that is, in the later stages. The thing is that the uterus, which has significantly increased in size, strongly displaces and compresses the intestines. As a result, the outflow of contents from the appendix is disturbed and inflammation develops.

Modern surgeons deny the influence of nutrition on the development of appendicitis. Seeds, fish bones and other products have not been the cause of inflammation of the appendix for a long time.

Other factors contributing to the development of appendicitis:

Worm infestations - ascariasis;
intestinal stones;
Scars on the caecum;
Neurological disorders that lead to impaired innervation and functioning of the caecum and appendix;
Decreased immunity;
Use a large number meat.

The listed factors and prerequisites for the development of appendicitis lead to the fact that the caecum and appendix become susceptible to infections that easily penetrate the intestinal wall. Therefore, the main (often the only) cause of appendicitis is an infection!

What forms of appendicitis occur in pregnant women?:

During pregnancy, women most often develop two forms of appendicitis:

Spicy;

Chronic, which is symptomatic during exacerbations against the background of an increase in the uterus and aggravation of the infectious and inflammatory process in the appendix.

Other forms of the disease - gangrenous, phlegmonous - are quite rare options during pregnancy.

Signs of acute appendicitis during pregnancy:

Appendicitis and its manifestations in the early stages

In the first and early second trimester, the manifestations of the disease are the same as in non-pregnant women. The most characteristic symptoms:

Sharp pains in the epigastric region. This department is easy to determine by the "triangle" rule. To do this, you need to draw an imaginary triangle, the base of which will pass above the navel, and the top - at the level of the ribs. All the space that is inside the triangle is the epigastrium;
Pain in the navel;
Pain throughout the abdomen;
Pain in the right iliac region - the right lower abdomen from the side of the appendix. Such pain does not appear immediately, but a few hours after the onset of the symptoms listed above;
Nausea;
Vomiting - single or repeated;
Increase in body temperature up to 37-37.6⁰С;
Increased heart rate;
Gray coating on the tongue;
Dryness of the tongue and mucous membranes of the oral cavity;
Bloating
The abdomen does not participate in breathing;

The rapid deterioration of a woman's condition occurs when acute appendicitis passes into more complex and severe forms - gangrenous or phlegmonous, as well as peritonitis. The main manifestations are as follows:

The increase in severe pain in the places listed above;
Manifestations of severe intoxication;
Increase in tachycardia;
A strong increase in body temperature up to 39⁰С;
Changes in the blood picture - the number of leukocytes is greatly increased, in particular the number of neutrophils increases;
This condition usually lasts for about two days.

In the future, the appendix breaks through - the so-called perforation of the wall occurs. A dangerous condition develops - peritonitis - inflammation of the abdominal cavity.

Features of symptoms in late pregnancy

In the second and third trimesters of pregnancy, the location of the appendix changes significantly. The pregnant uterus shifts it to the side:

kidneys;
Gallbladder;
Ureter;
Spine.

The infected appendix is removed from the peritoneum, which minimizes the risk of developing inflammation in the form of peritonitis. But danger lurks on the other side - an infection from an inflamed appendix can easily pass to the uterus and fetus. This process is often accompanied by contractions of the uterus, which threatens the onset of premature birth or the death of the fetus.
The main symptoms of appendicitis in late pregnancy:

1. Pain in the lumbar region;
2. Pain under the ribs on the right;
3. Rapid intensification of manifestations of intoxication;
4. A rapid increase in the number of neutrophils in the blood;
5. Increased ESR two days after the onset of the disease.

The same symptoms are accompanied by exacerbation of chronic appendicitis in pregnant women.

What conditions can be confused with appendicitis in pregnant women?:

Most often, timely diagnosis of the disease is difficult due to the fact that appendicitis is mistaken for such diseases and conditions of a woman who is carrying a baby:

1. Toxicosis of pregnant women;
2. Poisoning;
3. Pancreatitis;
4. Gallstone disease (cholecystitis);
5. Urolithiasis;
6. Infectious diseases;
7. Ectopic pregnancy;
8. Threat of abortion;
9. Increased tone of the uterus;
10. Premature detachment of the placenta;
11. Ovarian cyst;
12. Tumors of the abdominal organs.

How to quickly establish the correct diagnosis?:

Diagnosis methods are as follows:

Medical examination;
Gathering information about the presence of symptoms;
A blood test with a formula (of interest is the number of leukocytes, neutrophils, as well as ESR indicator);
Urinalysis to rule out infections of the woman's urinary system;
Ultrasound procedure. It is carried out in the presence of a gynecologist and a surgeon. Allows correct diagnosis in short time;
Laparoscopy. It is used in difficult cases to diagnose the disease. It is an invasive method, therefore, it is used extremely limitedly as a method of making a diagnosis in pregnant women.

Treatment of appendicitis in pregnant women:

If appendicitis has become inflamed, then it is impossible to treat the disease without urgent surgical intervention, just like waiting for the baby to be born. This insidious disease can't wait. You need to act quickly and decisively.
The operation to remove the appendix can be performed in two ways:

1. Traditional with incision;

2. Laparoscopy. This is a minimally invasive method, which involves making three small holes for the introduction of instruments, a laparoscope camera.

The operation is performed under anesthesia - local, general or spinal anesthesia. The method of anesthesia is selected only by the anesthesiologist, taking into account many factors of the patient's condition.

An operation to remove an appendicitis is not a sentence for a pregnant woman. Many women who had it for a period of 32-36 weeks successfully waited for the birth of a baby after the 40th week.

Complications of appendicitis:

Inflammation of the appendix is fraught with such complications:

1. Transition to more severe forms - gangrenous, phlegmonous;

2. Peritonitis - inflammation of closely spaced abdominal organs;

3. Premature birth;

4. Termination of pregnancy;

5. Death of the fetus.

The very fact of appendicitis in a pregnant woman, regardless of its form, is always anxiety state! All products formed in the body of a woman during the infectious and inflammatory process penetrate the fetus and can threaten its health. The diagnosis, established with a strong delay, often leads to the need for the use of strong antibacterial drugs and other drugs.

Modern medicine has reached such a level that pregnant women with appendicitis are helped without harm to the fetus and the need to cause premature delivery. It is important for a woman to undergo treatment in a specialized clinic, where there are both obstetrician-gynecologists and surgeons. By joint efforts, they will help the woman to completely get rid of the disease, endure and give birth to the baby on time.

Consequences of the operation:

Complications in the postoperative period in women who are expecting a baby develop much more often. These include the following:

Inflammatory processes of varying degrees;
Peritonitis;
Prolonged healing of sutures;
Anemia;
miscarriage;
premature birth. It is important that the gynecologist prescribes medications that reduce the tone of the uterus and prevent premature birth or spontaneous abortion;
Injury to the fetus and uterus;
The need to take medications that adversely affect the fetus (including antibiotics);
The need for delivery by caesarean section and at an earlier date.

What is prohibited for pregnant women with suspected appendicitis?:

Every woman should understand that it is impossible to make a diagnosis on her own. With the appearance of unpleasant symptoms, and even more so with their rapid increase, it is necessary to immediately call an ambulance!

Many sufferers seek a range of measures that they believe will help relieve pain and other symptoms. Remember what to do is strictly prohibited:

1. Apply any heat to the painful area;
2. Massaging;
3. Take painkillers, especially very strong ones. This will greatly complicate the work of the doctor;
4. Accept any medicines, including folk or homeopathic
5. Give enemas or take laxatives;
6. Eat.

Remember, the help of a doctor is required. After all, it is not only about your health, but also the safe birth of a healthy baby!