Bonfante Ramírez E, Estrada Altamirano A, Bolaños Ancona R, Juárez Garcia L, Castelazo Morales E
Instituto Nacional de Perinatología, Mex., D.F. Clínica de Embarazo de alto riesgo.
Ginecol Obstet Mex. 1998 Mar;66:126-8.
Acute appendicitis es the most common cause of lapparotomy during pregnancy. The differential diagnosis in the pregnant woman becomes a challenge due to the anatomic changes that take place during the maternal adjustment to pregnancy. We have done a retrospective study between january 1989 and december 1994, at Instituto Nacional de Perinatologia. We found in that period of time 35,080 deliveries reported and 4 cases of acute appendicitis during pregnancy. The maternal age was between 16 and 42 years old, 26 years in average. Three patients were in the 3 trimester at the time of diagnosis, and the most important clinical sign was found to be diffuse abdominal pain. In 3 cases diagnosis was attributed to obstetric pathology rather than appendicitis in first place. Laparotomy and appendicectomy was done to all patients, with on block hysterectomy in only one case, having this particular patient an abscess as a postquirurgical complication. Just one case reported a healthy newborn delivered at term. It is obvious that early diagnosis and quirurgical treatment are important factors for the mother and the fetus prognosis. Appendicectomy as well as cholecystectomy are the two most common causes of laparotomy during pregnancy.
急性阑尾炎是孕期剖腹手术最常见的原因。由于孕期母体生理变化引起的解剖结构改变，孕妇的鉴别诊断成为一项挑战。我们于1989年1月至1994年12月在国立围产医学研究所进行了一项回顾性研究。在那段时间里，共报告了35080例分娩，其中4例孕期急性阑尾炎。产妇年龄在16至42岁之间，平均26岁。3例患者在诊断时处于孕晚期，最重要的临床症状是弥漫性腹痛。3例最初诊断归因于产科疾病而非阑尾炎。所有患者均接受了剖腹手术及阑尾切除术，仅1例患者同时行子宫切除术，该患者术后出现脓肿并发症。仅1例患者足月分娩出健康新生儿。显然，早期诊断和手术治疗对母亲和胎儿的预后至关重要。阑尾切除术和胆囊切除术是孕期剖腹手术最常见的两个原因。
