Results of the Diagnosis of Acute Appendicitis in Pregnant Women

Abstract

The purpose of the study was to evaluate the diagnostic effectiveness of clinical symptoms of acute appendicitis in non-pregnant and pregnant women at different stages of gestation. Materials and methods. 124 patients with a diagnosis of acute appendicitis were examined. All patients were divided into 2 groups. The first group consisted of pregnant women of different gestational ages, the second group – comparison group consisted of non-pregnant women. The informativeness of such symptoms as Kocher-Volkovich, Rovzing, Bartomier-Michelson, Sitkovsky, Gabay, Brando, Michelson, Ivanov has been studied. Results and discussion. Pain syndrome was noted in all examined women of groups 1 and 2. The localization of pain in women of group 1 was varied and depended on the term of pregnancy. Most often the pain was observed in the epigastrium, followed by dislocation in the right iliac region. There was a significant decrease in the manifestations of such migration with each subsequent trimester. From the second half of pregnancy, pain in acute appendicitis was more often localized in the upper abdomen, namely in the right mesogastric region. There was a tendency to increase the frequency of pain in the right hypochondrium with increasing gestational age. In a small number of women, the pain was not clearly localized, was less pronounced. Pain in the lower abdomen, namely in the pubic and right groin areas was observed in isolated cases and only in early pregnancy. In women of group 2 in most cases the localization of pain was observed in the epigastrium with subsequent migration to the right iliac region. All symptoms had different qualitative characteristics. For non-pregnant women, the most informative were the symptoms of Kocher-Volkovich, Rovzing, in particular, their characteristics such as accuracy, sensitivity and efficiency, the level of which significantly exceeded the corresponding values in pregnant women. The diagnostic efficacy of symptoms such as Bartomier-Michelson and Sitkovsky was significantly higher in the group of pregnant women. The frequency of symptoms of acute appendicitis, which are characteristic of the pregnancy of Brando, Michelson and Ivanov, was maximal in the second trimester. Conclusion. Thus, the pain was accompanied by acute appendicitis in all women of both groups. The location of pain in pregnant women varied depending on the gestational age. Significant are specific clinical symptoms: Bartomier-Michelson, Sitkovsky, Brando, Michelson, Ivanov in the correct diagnosis of acute appendicitis in pregnant women. They should be considered as characteristic symptoms of acute appendicitis during pregnancy