ABSTRACT
Acute appendicitis is the most common nonobstetrical surgical condition of the abdomen complicating pregnancy. Appendectomy reportedly is performed during pregnancy once for every 1,500 deliveries. Although the incidence of appendicitis occurring in pregnant women is considered to be the same as in nonpregnant women, the signs and symptoms, and the laboratory findings usually associated with appendicitis in the nonpregnant condition, are frequently unreliable during pregnancy. Using the Computer Diagnostic Data System, we completed a retrospective analysis on all appendectomies performed at two Army Medical Activities (MEDDACs) during a 2-year period. With a representative large Army MEDDAC and a representative medium-sized Army MEDDAC studied, the incidence of appendectomy during pregnancy was the same frequency as in previous reports. The only consistent finding in all pregnant patients who underwent appendectomy was right lower quadrant abdominal pain. Presenting signs and symptoms, clinical evaluations, laboratory findings, and surgical management is discussed. No morbidity or mortality occurred during this study.
Subject(s)
Appendectomy/statistics & numerical data , Appendicitis/diagnosis , Appendicitis/surgery , Military Medicine/statistics & numerical data , Military Personnel , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/surgery , Abdominal Pain/etiology , Adolescent , Adult , Appendectomy/methods , Appendicitis/complications , Appendicitis/epidemiology , Delivery, Obstetric/statistics & numerical data , Diagnosis, Differential , Female , Humans , Incidence , Kentucky/epidemiology , Laparoscopy/statistics & numerical data , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Retrospective Studies , Virginia/epidemiologyABSTRACT
Amniorrhexis complicates pregnancies if it occurs in a preterm pregnancy or remote from the onset of labor in a term pregnancy. There are different collagen types (I-V) that create the extracellular matrix of the amnion. Collagenases specific to these collagen types, with the exception of type V collagen, are found in human amniotic fluid, fibroblasts, polymorphonuclear leukocytes and bacteria. Type V collagen is a major component of the amniotic basement membrane and is responsible for maintaining a barrier to bacteria and to the loss of amniotic fluid. We sought to find evidence of type V collagenolytic activity in human amniotic fluid obtained from pregnancies in different clinical states.
Subject(s)
Amniotic Fluid/enzymology , Microbial Collagenase/analysis , Amniocentesis , Amnion/chemistry , Amnion/enzymology , Autoradiography , Bacteria/enzymology , Basement Membrane/chemistry , Collagen/analysis , Collagen/classification , Collagenases/analysis , Electrophoresis, Polyacrylamide Gel , Extracellular Matrix Proteins/analysis , Female , Fetal Membranes, Premature Rupture/enzymology , Fetal Organ Maturity , Fibroblasts/enzymology , Genetic Testing , Humans , Lung/embryology , Matrix Metalloproteinase 8 , Neutrophils/enzymology , Obstetric Labor, Premature/enzymology , Pilot Projects , Placenta/enzymology , Pregnancy , Sodium Dodecyl Sulfate , Surface-Active AgentsSubject(s)
Fallopian Tube Diseases/surgery , Laparoscopy , Ovarian Cysts/surgery , Pregnancy Complications/surgery , Adult , Appendicitis/diagnosis , Appendicitis/surgery , Diagnosis, Differential , Fallopian Tube Diseases/diagnosis , Female , Humans , Ovarian Cysts/diagnosis , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Trimester, FirstABSTRACT
This is a brief report on the medical support provided to an aviation brigade from September 1, 1990 to November 1, 1990, deployed during Operation Desert Shield. The aviation brigade consisted of 1,400 personnel including attachments. Medical support was provided by 3 physicians, a physician's assistant, and 24 enlisted personnel. Daily patient load was 2.5% of the unit strength.
