Acute abdomen in pregnancy and postpartum period

  • Mate Majerovic
  • Goran Augustin
Keywords: acute abdomen, pregnancy, appendicitis, cholecystitis, intestinal obstruction, pancreatitis, hepatic rupture


Acute abdomen in pregnancy remains one of the most challenging diagnostic and therapeutic dilemmas today. The incidence of acute abdomen during pregnancy is 1 in 500-635 pregnancies. Despite advancements in medical technology, preoperative diagnosis of acute abdominal conditions is still inaccurate. Laboratory parameters are not specific and are often altered as a physiologic consequence of pregnancy. The use of laparoscopic procedures as diagnostic tools makes diagnosis of such conditions earlier, more accurate and safer. Appendicitis is the most common cause of the acute abdomen during pregnancy, occurring with a usual frequency of 1 in 500-2000 pregnancies, which amounts to 25% of operative indications for non-obstetric surgery during pregnancy. Surgical treatment is indicated in most cases, as in nonpregnant women. Laparoscopic procedures in the treatment of acute abdomen in pregnancy proved safe and accurate, and in selected groups of patients are becoming the procedures of choice with a perspective for the widening of such indications with more frequent use and subsequent optimal results. Despite these advances, laparotomy still remains the procedure of choice in complicated and uncertain cases.


Download data is not yet available.


Coleman NT, Trianfo VA, Rund DA. Nonobstetric emergencies in pregnancy: trauma and surgical conditions. Am J Obstet Gynecol 1997;177:497-502.

Mazze RI, Kallen B. Appendectomy during pregnancy: a Swedish registry study of 778 cases. Obstet Gynecol 1991;77:835-40.

Kanal E, Borgstede JP, Barkovich AJ, et al. American College of Radiology White Paper on MR Safety: 2004 update and revisions. AJR Am J Roentgenol 2004;182:1111- 4.

Halvorsen AC, Brandt B, Andreasen JJ. Acute appendicitis in pregnancy: complications and subsequent management. Eur J Surg 1992;158:603-6.

Society of American Gastrointestinal and Endoscopic Surgeons. Guidelines for Diagnosis, Treatment and Use of Laparoscopy for Surgical Problems during Pregnancy.

Karsenti D, Bacq Y, Brechot JF, et al. Serum amylase and lipase activities in normal pregnancy: a prospective case–control study. Am J Gastroenterol 2001;96:697-9.

Devore GR, Braken M, Berkowitz RL. The amylase/creatinine clearance ratio in normal pregnancies and pregnancies complicated by pancreatitis, hyperemesis, and toxemia. Am J Obstet Gynecol 1980;136:747-54.

Pratt AT, Donaldson RC, Evertson LR, et al. Cecal volvulus in pregnancy. Obstet Gynecol 1981;57(Suppl.):37S-40S.

Orchard JL, Mekha R, Khan H. The use of colonoscopy in the treatment of colonic volvulus: three cases and review of the literature. Am J Gastroenterol 1984;79:864-7.

Smith Jr LG, Moise Jr KJ, Dildy III GA, et al. Spontaneous rupture of the liver during pregnancy: current therapy. Obstet Gynecol 1991;77:171-5.

How to Cite
Majerovic M, Augustin G. Acute abdomen in pregnancy and postpartum period. Acta Chir. Croat. [Internet]. 2012Mar.15 [cited 2021Jul.25];9(1):13-7. Available from:

Most read articles by the same author(s)