Octavian Andronic (Bucharest / RO; Bucuresti / RO), Amalia Voinea (Timișoara / RO), Tibiana Negru (Timișoara / RO), Stelian Pantea (Timișoara / RO), Alin Mihai Vasilescu (Iasi / RO), Costel Bradea (Iasi / RO), Cristian Lupascu (Iasi / RO), Cătălin Cosma (Târgu Mureș / RO), Ludovic-Alexandru Szanto (Târgu Mureș / RO), Călin Molnar (Târgu Mureș / RO), Daniel Preda (Craiova / RO), Emil Moraru (Craiova / RO), Ștefan Paitici (Craiova / RO), Ștefania Tudorache (Craiova / RO), Marin Valeriu Șurlin (Craiova / RO), Nikolaos Zygouropoulos (Bucuresti / RO; Bucharest / RO), Bogdan Socea (Bucharest / RO; Bucuresti / RO), Mihai Dimitriu (Bucuresti / RO; Bucharest / RO), Alexandru Carâp (Bucuresti / RO; Bucharest / RO), Dan Nicolae Păduraru (Bucharest / RO; Bucuresti / RO), Alexandra Bolocan (Bucharest / RO; Bucuresti / RO), Răzvan Albu (Timișoara / RO), Tamas Talpai (Timișoara / RO), Cătălin Alexandru Pîrvu (Timișoara / RO), Daniel Ion (Bucuresti / RO; Bucharest / RO)
Abstract text (incl. references and figure legends)
Introduction
Surgical emergencies in pregnancy are a relatively rare entity, but whose management must be as prompt as possible in order not to have repercussions on the pregnant woman or the fetus. Both the precipitation and the postponement of the surgical moment can cause serious complications on the pregnancy, the vital risk being high. The diagnosis of these pathologies can be difficult both due to the physiological changes during pregnancy -as well as due to the restrictions imposed in what imaging investigations can be done which may have a detrimental effect to the fetus including teratogenic risk. The current study aims to analyze cases of surgical emergencies in pregnant women.
Material and methodsThe study had a retrospective design - it analyzed the patients hospitalized between 2017-2022, multicentric - the cases were selected from 6 general surgery clinics in 5 cities in Romania and descriptive. The eligibility criteria for inclusion in the studio were: admission to the general surgery department, pregnancy, discharge diagnosis with specific surgical emergency.
ResultsA total of 70 cases between the ages of 16 and 45 were identified. The most frequent surgical diagnoses were acute appendicitis (20/70) and cholecysto-pancreatic pathologies (23/70). The management was surgical in 44/70 cases under spinal anesthesia in 11/44 cases, under general anesthesia with orotracheal intubation 29/44 and local anesthesia in 4/44 cases. The median value of leukocytes at admission was 11.3 (6.36-24.45). Out of all 70 cases, only one death was recorded. In 2 cases, the fetus had to be extracted during the surgical intervention.
ConclusionsIn the case of the patient with an ongoing pregnancy, the suspicion of acute abdomen must be treated with maximum attention because the delay in the diagnosis can have severe consequences. On the other hand, prompt management (conservative or operator) has a favorable prognosis for both the mother and the child.
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