NGHIÊN CỨU CHẨN ĐOÁN VÀ XỬ TRÍ MỘT SỐ CẤP CỨU BỤNG NGOẠI KHOA Ở PHỤ NỮ MANG THAI

Abstract

Objective: To describe the clinical and paraclinical features of surgical abdominal emergencies in pregnant women. Subjects and methods: Cross-sectional descriptive study on 157 pregnant women admitted for surgical abdominal emergencies at National Hospital of Obstetrics and Gynecology and the Abdominal Emergency Department of Viet Duc University Hospital, over a period of 5 years from January 2019 to December 2023. Some factors related to clinical and paraclinical symptoms were recorded and analyzed. Results: In our study, the most common surgical abdominal emergencies in pregnant women were appendix-related diseases accounting for 68.8%, bowel-related diseases accounting for 16.6%, gallbladder diseases accounting for 8.8%, acute pancreatitis 3.8% and kidney diseases 3.8%. The mean age of the study group was 28.31±5.47; The most common gestational age was the second trimester (46.5%), followed by the third trimester (35%) and the gestational age rate in the first trimester was 18.5%. The average leukocyte count at admission was 12.91 ± 3.81 (G/l), 73.2% of pregnant women had a leukocyte count ≥ 10 G/l, neutrophils ≥ 70% predominating (90.4%). 100% of pregnant women had an ultrasound upon admission, 73/157 cases had typical ultrasound images. 47/157 cases were indicated for magnetic resonance imaging for diagnosis. In the appendix pathology group: 53.7% had typical ultrasound images and 28.7% had magnetic resonance imaging. In the group of gallbladder diseases, only 28.6% had typical ultrasound images and the rate of magnetic resonance imaging was 35.7%. 30.4% of pregnant women with intestinal diseases had typical ultrasound images and 30.4% had magnetic resonance imaging. In the group of patients with acute pancreatitis and the group of kidney-related diseases, these rates were 33.3% and 33.3%, respectively. Conclusion: The most common surgical abdominal emergency during pregnancy is appendix-related disease, followed by diseases related to the gallbladder, intestines, pancreas and kidneys. Ultrasound is the first choice to examine the abdomen during pregnancy and magnetic resonance imaging (MRI) is the second preferred imaging method when ultrasound is inconclusive.