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ALGORITHM FOR DIAGNOSIS OF ACUTE APPENDICITIS
IN PREGNANT WOMEN
Kasimova S.A.
Andijan State Medical Institute
https://doi.org/10.5281/zenodo.14202237
Relevance.
Regardless of the duration of pain and gestational age, a
clinically confirmed diagnosis of acute appendicitis requires immediate surgical
intervention. In the study groups, diagnostic errors in the pre-hospital stage,
especially associated with prolonged gestation, were high. In the retrospective
subgroup of the study, this diagnosis was confirmed in 34% of 45 pregnant
women with suspected acute appendicitis within the first 4-8 hours, and in
44.4% of 90 pregnant women in the prospective group, which clearly
demonstrates the difficulties in diagnosing acute appendicitis in pregnant
women. Diagnostic errors in the II and III trimesters of pregnancy were
observed in 16.7%. Incorrect diagnoses at referral: threat of premature
termination of pregnancy, acute pyelonephritis, renal colic, gastritis, duodenal
ulcer, "acute abdomen". Errors in diagnosis can lead to inappropriate
hospitalization, delayed treatment, and other complications.
Aim.
To improve the results of surgical treatment of acute appendicitis in
pregnant women.
Algorithm.
This algorithm was used in all 90 patients of the main group.
In the first stage, the diagnosis of acute appendicitis in pregnant women in
all study groups was based on the assessment of painful and paraclinical
symptoms, as well as laboratory parameters.
As a second diagnostic stage, an abdominal ultrasound examination was
performed in all pregnant women in the main group.
Diagnostic laparoscopy was the 3rd stage of the algorithm, which was
performed in pregnant women in the I and II trimesters, who did not confirm or
exclude the diagnosis of acute appendicitis within 2-4 hours.
When comparing the two groups, in the main group (where the proposed
diagnostic and treatment algorithm was used), an accurate diagnosis was
established in 11.4% of patients within the first 3 hours, and in the comparison
group (where the proposed diagnostic and treatment algorithm was not used),
this was 8% of patients. In the first 3-6 hours, the diagnosis of acute appendicitis
was established in 24.3% of the main group and 16% of the comparison group.
In the main group, most patients spent 6-12 hours to verify the diagnosis, while
in the comparison group - up to a day (40% in both groups). When using the
MODELS AND METHODS IN MODERN SCIENCE
International scientific-online conference
179
proposed diagnostic and treatment algorithm, an accurate diagnosis was made
in 76.7% of patients within the first 12 hours, while in other cases this result
was achieved in 48% of patients. It is known that the diagnosis of acute
appendicitis in different trimesters of pregnancy is quite difficult, and errors and
delays in diagnosis can lead to various obstetric and surgical complications. In
order to solve this problem, by using the staged diagnosis and treatment
algorithm developed and proposed by us, it was possible to reduce the period of
diagnosis of acute appendicitis in pregnant women by 1.6 times.
