Non-obstetric surgery during pregnancy

Abstract

Summary Diseases of the abdomen (cholecystitis, appendicitis, adnexal masses), although they rarely occur during pregnancy, pose a threat both to the gravid women and the fetus. We attempt to systemize current knowledge on the topic and to outline some diagnostic and therapeutic trends. Appendicitis is very difficult to diagnose during pregnancy. If the diagnosis is set, appendectomy should not be postponed. Diagnostic methods (ultrasonography and others) are useful in the diagnosis of adnexal masses and cholecystitis, while in case of cholecystolithiasis, the typical symptoms are similar to those occurring before pregnancy. Platk’s at all algorithm, together with Nowak’s at all modifications, may be used in the treatment of adnexal masses. However, the type of inflammation, the response to conservative treatment and the number of relapses have a great influence on the choice of cholecystitis treatment (conservative vs. surgical). In any of the above situations it is also very important to state the most safe stage of the pregnancy to make the operation. In the event of direct threat to the mother and/or fetus, surgical intervention should be conducted regardless of the stage of pregnancy.