Spectrum of Pathologies in Patients Presenting with Acute Abdomen during Pregnancy

Aim: To see the spectrum of pathological diagnosis its management in cases of acute abdomen in pregnancy, both in OPD and emergency. Study Design: Prospective Study. Place and Time of study: Department of Surgery, Khawaja Muhammad Safdar Medical College, Sialkot. From April 2016 to December 2018. Methods: Between April 2016 and December 2018; A total of 239 patients presenting with abdominal pain having gestation of any duration were enrolled and the record maintained of the progress of investigations and management carried in the surgical department. These patients were grouped in group I and II depending upon their initial presentation whether it was in OPD or in Emergency department. follow up visits conducted and proformas/ questionnaire filled, while subsequent visits were conducted. Following data was recorded: Age, gestational duration, presentation at OPD or emergency, comorbid conditions, Investigations, Blood CE, Bilirubin, alkaline phosphatase, serum amylase, whether admitted or opd treatment given, surgery done or managed conservatively. Complications like wound infection, Investigations like ultrasound abdomen and liver function tests were repeated in follow up visits. Minimum 3 months follow up was mandatory for inclusion in the study. Results: The diagnosis which were made in patients of Group I and Group II as: 19% patients of Group I & 22% of Group II had Acid peptic disease, 15% of Group I & 6.(% of Group II were having urinary tract infections, 8% of Group I patients had functional pain. Acute appendicitis was a diagnosis in 26% of Group I & 37% of Group II patients, & acute cholecystitis was present in 15% of Group I and 19% of Group II patients. Group I patients having intestinal obstruction were 11% while Group II patients having this problem were also 11%. Conclusion: Acute abdomen in pregnancy is a quire common presentation both in emergency and opd settings of general surgical department. Although the mainstay of treatment remains conservative treatment to protect from fetal complications but the situations demand emergency surgeries due to unavoidable indications to preserve maternal life