Acute appendicitis complicating pregnancy in the Oxford region

Finch, D. R. A.; Lee, Emanoel

doi:10.1002/bjs.1800610214

Cited by 31 publications

(10 citation statements)

References 5 publications

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“…However, in their controlled clinical trials, Craig [30], Howes et al [31] and Finch and Lee [32] used ampicillin for which no penetration into pancreatic tissue has been shown later.…”

Section: Clinical Trials To Evaluate Antibiotic Prophylaxis Of Severementioning

confidence: 99%

Antibiotic prophylaxis in severe acute pancreatitis

et al. 2005

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“…However, in their controlled clinical trials, Craig [30], Howes et al [31] and Finch and Lee [32] used ampicillin for which no penetration into pancreatic tissue has been shown later.…”

Section: Clinical Trials To Evaluate Antibiotic Prophylaxis Of Severementioning

confidence: 99%

Antibiotic prophylaxis in severe acute pancreatitis

et al. 2005

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“…Nothing is worse for the perinatal outcome and maternal health than peritonitis during pregnancy. 25 In this surgical dilemma, the surgeon may fear intervening and triggering unnecessary uterine contractions, or consider prolonging the hospital stay, which is unpredictable and costly. Although early surgical intervention may have resulted in negative laparotomies in this study, as seen from the high incidence of misdiagnosis (Table 4), it definitely resulted in a significantly better fetal outcome and better maternal health (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Acute Abdomen in Pregnancy: Are Tocolytics and Early Surgical Intervention Justified?

et al. 1998

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Acute abdomen in pregnancy due to nonobstetric causes is accompanied by a high incidence of poor fetal outcome and maternal morbidity.1,2 Delay in surgical intervention, together with the operative maneuvers, are the main causes of the poor outcome. [3][4][5] Fear of the complication of a negative laparotomy in a pregnant female makes surgeons hesitant to interfere surgically, leading them to await clear-cut symptoms and signs of acute abdomen. 5,6 In pregnancy, these symptoms and signs are blunted by the anatomical displacement of the pregnant uterus 7 and the masking effect of the physiological symptoms of normal pregnancy, such as nausea, vomiting, mild abdominal pain and constipation. 8,9 Ironically, this delay, when prolonged, carries a high risk to the mother and fetus. 4 In acute abdomen in pregnancy, some have advocated aggressive early surgical intervention, 10-11 while others have adopted an initial trial of conservative treatment before resorting to surgery in case of failure. 4,12 Tocolytics are thought to calm the uterus from the insult of acute abdomen during conservative management or surgery, but this is controversial.13,14 The purpose of this article is to discuss the high incidence of acute abdomen, the effect of early surgical intervention on the maternal fetal health, and to evaluate the effect of tocolytics on pregnancy outcome. Subjects and MethodsAll cases of acute abdomen in pregnancy due to non-obstetric causes that were admitted to Asir Central Hospital (the main referral hospital in the region) from January 1991 to December 1993 were studied and analyzed. The parameters examined included the gestational age, acute abdomen symptoms and their duration before admission, signs, results of investigations, including ultrasound scanning, provisional diagnosis, the initial management plan (whether conservative or surgery and the criteria for either), tocolytic used, its nature, dose, side effects and its effects on the. fetal outcome, and whether abortion, preterm or term labor. Maternal morbidity was assessed by the duration of hospital stay, recurrent hospital admission, body temperature, nature of operation, postoperative complications and maternal health after delivery or abortion. The results of ultrasound scan and histopathology were compared to operative findings. The newborn charts were reviewed and any neonatal abnormality recorded.The chi-squared test, Fisher's exact test, and unpaired Student's t-test were used as tests of significance at the 5% level. For this purpose the software Statistical Package for Social Sciences (SPSS) was used. ResultsDuring the study period, there were 15,562 deliveries, of which 60 cases were provisionally diagnosed and admitted as having acute abdomen with pregnancy. The symptoms were severe abdominal pain, vomiting, constipation and signs of abdominal distension, rigidity, tenderness, abdominal mass, high temperature and rapid pulse. Table 1 summarizes the frequency of symptoms and signs.Depending on the severity of the above symptoms, patients were ei...

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“…The fetal loss was 4%, in patients in both their eleventh and twelfth week of gestation who had had pain for more than two days. Black [10] reported an overall fetal mortality of 17%; Finch and Lee [17], 7.1%; Mohammed and Oxhorn [18] 20%; and McDonald [19], who published his report during the preantibiotic era, cited 37%. We advocate the use of intraoperative antibiotics to reduce fetal mortality, with discontinuation after operation unless peritonitis or abscess arises.…”

Section: Discussionmentioning

confidence: 99%

Acute Appendicitis Complicating Pregnancy

et al. 1991

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Appendicitis occurring during pregnancy presents a difficult problem for both the treating gynecologist and the surgeon. We studied retrospectively the cases of 52 consecutive patients seen during a four-year period at Riyadh Central Hospital, a large and busy general hospital. The incidence of appendicitis in various stages of pregnancy, along with its symptomatology, physical signs, laboratory results, and operative findings, were analyzed. The rates of complications, especially maternal and fetal mortality, were also analyzed and findings compared with those reported elsewhere. There was no maternal mortality and a 4% fetal mortality. We concluded that an aggressive approach in the diagnosis and surgical management of these patients reduces the maternal and fetal mortality.

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Acute appendicitis complicating pregnancy in the Oxford region

Abstract: A study of 75 patients who were admitted to the Oxjord

Cited by 31 publications

References 5 publications

Antibiotic prophylaxis in severe acute pancreatitis

Antibiotic prophylaxis in severe acute pancreatitis

Acute Abdomen in Pregnancy: Are Tocolytics and Early Surgical Intervention Justified?

Acute Appendicitis Complicating Pregnancy

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