Acute abdomen in pregnancy : differentials

The diagnosis and treatment of acute abdomen in pregnancy (AAP) present a unique set of challenges. An acute abdomen refers to a serious intra-abdominal condition characterized by pain, tenderness, and muscle rigidity, often necessitating emergency surgery. It encompasses a wide range of clinical symptoms that can persist for varying durations, from minutes to weeks. While the term is sometimes used interchangeably for any abdominal ailment requiring urgent surgical intervention, the complexity of AAP arises from its diverse causes and clinical presentations.

Managing acute abdomen in pregnancy demands immediate attention and a multidisciplinary approach. Given the gravity of the situation, involving a team of professionals including general surgeons, obstetricians, maternal-fetal specialists, and radiologists is crucial for achieving the best possible outcomes. The approach to a pregnant patient with acute abdomen, as defined earlier, mirrors that of a non-pregnant individual, with necessary modifications.

AAP poses a distinct challenge in both diagnosis and treatment. The evaluation must consider not only the mother but also the developing fetus. Concerns about the potential adverse effects of anesthesia, medications, and radiation on the fetus often complicate the diagnostic process, occasionally leading to delayed intervention or invasive tests. There is a general reluctance to perform unnecessary...