acute abdominal conditions with pregnancy medical acute abdomen conditions with pregnancy surgical acute abdomen conditions with pregnancy

1. Acute abdomen with pregnancy
By
D Ahmed Mohamed Nasef
Assistant lecturer
Benha university

2. Any cause for acute abdomen can
occur coincident with pregnancy.
Some clinical conditions are more
likely to occur in pregnancy.
Other conditions are specific to
pregnancy.
Thus, a wide range of possible
differential diagnoses should be
considered

3. Causes of acute abdomen with
pregnancy

4. 1-Gastrointestinal (GI) causes
2-Genitourinary (GU) causes
3-Vascular causes
4-Respiratory causes
5-Causes associated with
pregnancy
6-Additional causes of acute
abdomen that are incidental
to pregnancy

5. Gastrointestinal (GI) causes of acute abdomen that are
incidental to pregnancy include the following:
Acute appendicitis
Acute pancreatitis
Peptic ulcer
Gastroenteritis
Hepatitis
Bowel obstruction
Bowel perforation
Herniation
Meckel diverticulitis
Toxic megacolon
Pancreatic pseudocyst

6. Genitourinary (GU) causes of
acute abdomen that are
incidental to pregnancy include
the following:
Ovarian cyst rupture
Adnexal torsion
Ureteral calculus
Rupture of renal pelvis
Ureteral obstruction

7. Vascular causes of acute abdomen
that are incidental to pregnancy
include the following:
Superior mesenteric artery syndrome
Thrombosis/infarction (specifically,
mesenteric venous thrombosis)
Ruptured visceral artery aneurysm
Splenic artery aneurysm

8. Respiratory causes of acute
abdomen that are incidental
to pregnancy include the
following:
Pneumonia
Pulmonary embolism (PE)

9. Additional causes of acute
abdomen that are incidental to
pregnancy include the following:
Intraperitoneal hemorrhage
Splenic rupture
Abdominal trauma
Acute intermittent porphyria
Diabetic ketoacidosis
Sickle cell disease

10. Causes associated with
pregnancy

11. Pregnancy-associated
conditions that cause acute
abdomen include the following:
Acute pyelonephritis
Acute cystitis
Acute cholecystitis
Acute fatty liver of pregnancy
Rupture of the rectus abdominis
Torsion of the pregnant uterus

12. Conditions resulting from
pregnancy that cause acute
abdomen in early pregnancy
include the following:
Ruptured ectopic pregnancy
Septic abortion with peritonitis
Acute urinary retention due to
retroverted gravid uterus

13. Conditions resulting from pregnancy that
cause acute abdomen in later pregnancy
include the following:
Red degeneration of myoma
Torsion of pedunculated myoma
Placental abruption
Placenta percreta
HELLP (hemolysis, elevated liver function, and low
platelets) syndrome – Spontaneous rupture of the
liver
Uterine rupture
Chorioamnionitis

14. Management

15. Management should include
full history taking
examination (general, abdominal)
investigations as regard to
suspected clinical condition
radiology (ultrasonography, MRI…)

16. Obstetric concerns in managing acute
abdomen with pregnancy
care for the fetus
if preterm labor is suspected ---
glucocorticoids for lung maturity&
tocolytics may be needed
documented ultrasound pre& post
operative for medicolegal purposes