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General Surgery Emergencies in Pregnancy

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Mini-invasive Approach in Acute Care Surgery

Part of the book series: Hot Topics in Acute Care Surgery and Trauma ((HTACST))

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Abstract

Acute abdominal surgical conditions in pregnancy pose unique challenges for healthcare providers. These conditions can be life-threatening to both the mother and the fetus, requiring prompt diagnosis and management. The most common acute abdominal surgical conditions during pregnancy are acute appendicitis, acute cholecystitis, bowel obstruction, and abdominal trauma. The clinical presentation of these conditions may be atypical, making accurate diagnosis difficult.

The management of acute abdominal surgical conditions in pregnancy requires a multidisciplinary approach, involving obstetricians, surgeons, and anesthesiologists. The decision to operate depends on several factors, including the gestational age of the fetus, maternal condition, and severity of the condition. Surgical interventions during pregnancy carry additional risks, such as preterm labor, fetal distress, and maternal hemorrhage.

The diagnosis and management of acute abdominal surgical conditions in pregnancy are further complicated by the limited diagnostic and therapeutic options available during pregnancy. Imaging modalities such as ultrasound and magnetic resonance imaging (MRI) are safe for the fetus but have limited sensitivity and specificity. Radiation exposure from computed tomography (CT) should be avoided unless absolutely necessary.

Laparoscopic access for acute abdominal conditions in pregnancy is rising. It results in faster recovery, less pain, minimal abdominal wall trauma, and early ambulation. Avoiding laparotomies during pregnancy minimizes the possibility of ventral hernia due to the pressure effect of the growing uterus and abdominal wall muscle contractions during labor.

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Authors and Affiliations

  1. School of Medicine University of Zagreb, University Hospital Centre Zagreb, Croatian Academy of Medical Sciences, Zagreb, Croatia

    Goran Augustin

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  1. Goran Augustin
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Editors and Affiliations

  1. General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Pisa, Italy

    Federico Coccolini

  2. Emergency Surgery Department, Cagliari University Hospital, A.O.U. di Cagliari, Monserrato, Cagliari, Italy

    Mauro Podda

  3. Oklahoma Univ. School of Med. at Tulsa, Tulsa, OK, USA

    Robert B. Lim

  4. General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Pisa, Italy

    Massimo Chiarugi

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Augustin, G. (2023). General Surgery Emergencies in Pregnancy. In: Coccolini, F., Podda, M., Lim, R.B., Chiarugi, M. (eds) Mini-invasive Approach in Acute Care Surgery. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-031-39001-2_19

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