ABSTRACT
Summary Objective: To investigate whether the diagnosis of acute appendicitis is affected by pregnancy or not. Method: A retrospective study with the analysis of the medical records of all women suspected of having appendicitis who underwent appendectomy at our hospital between June 2010 and March 2015 were reviewed. The patients were divided into two groups according to whether they were pregnant or not during the surgery: group I, pregnant women, and group II, non-pregnant women. Results: During the study period, 38 pregnant women and 169 non-pregnant women underwent appendectomy. The time from admission to the operation was not statistically different (2.17±1.47 days in group I vs. 1.98±1.66 day in group II; p=0.288). The pregnant group had longer hospital stay than the non-pregnant group (p=0.04). Ultrasonography (USG) was used as the first diagnostic modality in 36/38 patients in group I and 161/169 in group II. The non-visualized appendix on ultrasound was seen in 17 patients in group I and 51 patients in group II, which was not statistically different. Sensitivity and specificity of USG in diagnosis of acute appendicitis were 61.29 and 80.00% in group I, and 93.0 and 31.6% in group II, respectively. Conclusion: Although the diagnosis of appendicitis in pregnant women is not delayed, careful assessment of these patients suspected of having appendicitis should be encouraged when USG examination is normal or nondiagnostic.
Resumo Objetivo: investigar se o diagnóstico de apendicite aguda é afetado por gravidez ou não. Método: estudo retrospectivo com análise dos prontuários médicos de todas as mulheres que tiveram suspeita de apendicite e foram submetidas à apendicectomia em nosso hospital entre junho de 2010 e março de 2015. As pacientes foram divididas em dois grupos, de acordo com a presença de gravidez durante a cirurgia: grupo I, mulheres grávidas; grupo II, mulheres não grávidas. Resultados: durante o período do estudo, 38 mulheres grávidas e 169 mulheres não grávidas foram submetidas à apendicectomia. O tempo desde a internação até a cirurgia não foi estatisticamente diferente (2,17±1,47 dias no grupo I vs. 1,98±1,66 dia no grupo II, p=0,288). O grupo das grávidas apresentou uma estadia hospitalar mais longa que o grupo das não grávidas (p=0,04). A ultrassonografia foi usada como primeira modalidade de diagnóstico em 36/38 pacientes no grupo I e em 161/169 no grupo II. O apêndice não visualizado na ultrassonografia foi visto em 17 pacientes no grupo I e 51 pacientes no grupo II, e não foi estatisticamente diferente. A sensibilidade e especificidade da ultrassonografia no diagnóstico de apendicite aguda foram 61,29 e 80,00% no grupo I e 93,0 e 31,6% no grupo II, respectivamente. Conclusão: embora o diagnóstico de apendicite em mulheres grávidas não seja protelado, recomenda-se uma avaliação cuidadosa quando o exame de ultrassonografia for normal ou não diagnóstico nessas pacientes.
Subject(s)
Humans , Female , Pregnancy , Adult , Young Adult , Appendicitis/diagnostic imaging , Appendectomy/methods , Appendicitis/surgery , Acute Disease , Retrospective Studies , Risk Factors , Ultrasonography/methods , Sensitivity and Specificity , Laparoscopy/methods , Statistics, Nonparametric , Middle AgedABSTRACT
Objective: To report a case of pregnant woman with low thrombocyte count which in fact has spurious thrombocytopenia. Methods: A 40-week pregnant woman was admitted to our obstetric clinic with complaint and signs of active labour. She was hospitalized and followed for the vaginal birth. Results: On laboratory examination, the low platelet (Plt) count as 42 x 103/mm3 was measured by using blood samples with ethylenediaminetetraacetic acid (EDTA). Patient had no history for echymosis, bleeding disorders and bruising. She underwent a differential diagnosis for thrombocytopenia in term pregnancy for preeclampsia, HELLP syndrome, acute fatty liver disease or immune thrombocytopenic purpura and no pathology was found. The peripheral blood smear showed platelet (plt) clustering with normal count as 181 x 103/mm3. She diagnosed as pseudothrombocytopenia. The patient delivered a healthy baby with vaginal way and had no bleeding complication in pospartum period. Conclusion: Thrombocytopenia in pregnancy is a challenging and important issue for obstetrician. We aimed to point out that low Plt count doesn’t indicate always a serious disease in term pregnancy. Pseudothrombocytopenia should be kept in mind which may cause unnecessary laboratory examination and treatments.