By Goran Augustin
This ebook might help the reader to acknowledge, diagnose, and deal with many of the acute stomach issues which may be encountered within the pregnant sufferer, no matter if linked to or incidental to the being pregnant. a variety of stipulations are addressed, together with a few that are very infrequent in addition to these extra often visible, reminiscent of acute appendicitis and acute cholecystitis. the rules underlying analysis and remedy are basically defined. specific positive factors within the scientific presentation of pregnant sufferers are highlighted, and particular diagnostic and healing algorithms and protocols, defined. cognizance is interested in the diagnostic problems that can come up from peculiar shows and to regulations at the use of definite diagnostic imaging reports. The publication is designed to fulfill the wishes of either the gynecologist and the final or belly health care professional, who jointly shape the multidisciplinary group vital for potent remedy that would protect mom and baby.
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Extra info for Acute Abdomen During Pregnancy
It is recommended to continually remove the smoke produced by tissue fulguration . Harmonic scissors produce vapor-free gas, avoiding the potential effects of carbon monoxide . Other negative effect of electrocautery is the potential for uterine irritation. There are many advantages of laparoscopic technique. Authors note that laparoscopy expands the ability to explore the abdomen with less uterine manipulation . Further, it increases the ability to locate and treat the ectopic appendix and results in relatively small incisions compared with the open technique or helps in detecting other unexpected sources of pain [147, 148].
1 Muscle Splitting Incision (McBurney’s Incision, Gridiron Incision) This is the incision of choice for open approach for the removal of the appendix in pregnant patients in all trimesters. In the latter pregnancy, the incision could be positioned above McBurney’s incision because of possible displacement of the appendix in the right upper quadrant. This change of the location of the incision is not necessary because the appendix was easily located in 94 % of the incisions made through McBurney’s point and in 80 % of the incisions made above McBurney’s point .
This has led some to recommend only pre- and postoperative monitoring of the fetal heart rate as no increased fetal morbidity has been reported [160, 162]. The effects of general anesthesia on cardiotocography result in a reduction of beat-to-beat variation with normal baseline frequency. The decreased variability can persist until 90 min in the postoperative course due to the residual effects of anesthetic agents on the fetus. This could be misinterpreted as fetal distress leading to emergency delivery and hence adding to fetal morbidity and mortality .