A prospective cohort study of non-obstetric surgical emergencies complicating pregnancy

Abstract

Background: During pregnancy, 0.2% to 1.0% of women require general surgery for a non-obstetric problem. The evaluation, work-up, and management of pregnant patients are essential in the practice of emergency medicine to avert maternal and fetal morbidity and mortality. The aims and objectives of this study were to study the common causes of acute abdomen in pregnancy and there management. Methods: Ours was a prospective cohort study of 50 pregnant patients presenting with a non-obstetric surgical emergency over a period of 1 year in a tertiary care hospital of a developing area. Results: The mean age of the patients was 27.4 ± 4.73 years with most of them being in the age group of 26-30 years. Majority of patients presented in the 2 nd trimester [22 (44%)]. Ultrasonography was used as the diagnostic modality of choice in 49 (98%) patients. Acute cholecystitis was the most common surgical emergency in our study group accounting for 28% of all the emergencies, followed by acute appendicitis (14%), urinary tract infections (12%), urolithiasis (12%) and acute pancreatitis (6%). Conclusion: Early suspicion and serial examination in pregnancy may result in appropriate interventions for non-obstetric surgical emergencies. Surgeons should not be hesitant in ordering imaging modalities. Ultrasonography is most common and most useful diagnostic modality in pregnancy.