Early marriage before the peak age for appendicitis, which is the most common cause of acute abdomen in this and other studies, and repeated pregnancies in this population, going on well into advanced age, gives a higher probability for acute abdomen occurring during a pregnancy cycle. Early marriages with repeated pregnancies 16 and the well-documented deleterious effects of pregnancy on the biliary system are other possible causes. Most of the women in this society are obese and live a sedentary life with a diet rich in fat and carbohydrates. The early symptoms of an acute abdomen resemble the common symptoms of pregnancy, such as nausea, vomiting, mild abdominal pain and constipation, and it is this resemblance which precludes the possibility of a definitive early diagnosis. Ironically, when symptoms and signs clearly indicate ending conservative management and embarking on surgery, as often happens when some cases present late, the peritonitis may have spread uncontrollably, as the omentum has little space to move and localize the infection.
Nothing is worse for the perinatal outcome and maternal health than peritonitis during pregnancy.
In this surgical dilemma, the surgeon may fear intervening and triggering unnecessary uterine contractions, or consider prolonging the hospital stay, which is unpredictable and costly. Effect of individual tocolytic, all tocolytics and no tocolytic on fetal outcome. Percentage of misdiagnoses in acute abdomen during pregnancy. Prophylactic tocolytics were thought by some to help in this situation by calming the uterus during conservative management or surgery, but from the above study they were not as beneficial as has been reported by other authors. Ritodrine leads to rapid pulse and vomiting, so it masks some important clinical findings.