Laparoscopic Value in the Management of Acute Abdomen During Pregnancy

Study Overview
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Brief Summary
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The term acute abdomen is often used to describe the manifestations of any serious intraperitoneal disease, which may indicates surgical intervention. Acute abdomen in pregnancy accounts for approximately 7-10% of all abdominal emergencies. Several pathologies could contribute acute abdominal pain during pregnancy. They include obstetric and non-obstetric causes. As for the non-obstetric causes , any gastrointestinal or urological disorders could be presented by an acute abdominal pain. In pregnancy, several factors overlap and making the diagnosis challenging. These factors include the distorted anatomy by the growing uterus that displaces intraperitoneal structures. Additionally, nausea, vomiting, and abdominal pain are considered the normal course during pregnancy especially at the first trimester. Moreover, sure diagnosis must be achieved to operate in a pregnant woman with more possible morbidity and mortality for the mother and\or fetus.

Detailed Description
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Laparoscopy can be safely performed during any trimester of pregnancy. Historical recommendations were to limit surgery to the second trimester only, but these recommendations were based on experience with open surgical procedures during pregnancy. These recommendations were thought to minimize the spontaneous abortion rate of surgical intervention during the first trimester, which was reported to be as high as 12%, and to avoid preterm labor, reported in up to 40%, when surgery occurred during the third trimester. However, studies limited to laparoscopy have shown improved outcomes and demonstrated that pregnant patients may undergo laparoscopic surgery safely during any trimester without any appreciated increase in risk to the mother or fetus.

Official Title
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Laparoscopic Value in the Management of Acute Abdomen During Pregnancy

Conditions
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Acute Abdomen, Pregnancy Related

Intervention / Treatment
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* Procedure: Laparoscopy vs Non-laparoscopy approach


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All pregnant women having acute abdomen and underwent surgical intervention will be included in this study. Exclusion Criteria: Non-pregnant women with acute abdomen are excluded.
Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Laparoscopy Group<br>The laparoscopy group included every pregnant woman having laparoscopic intervention because of acute abdominal pain during any trimester of her pregnancy. | Procedure: Laparoscopy vs Non-laparoscopy approach<br>* Pregnant women who will undergo a laparoscopic or open surgical exploration of the abdomen<br>|
| Non-laparoscopy Group<br>Non-laparoscopy Group included every pregnant woman having treatment approach other than the laparoscopic approach because of acute abdominal pain. | Procedure: Laparoscopy vs Non-laparoscopy approach<br>* Pregnant women who will undergo a laparoscopic or open surgical exploration of the abdomen<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Early complications for the mother and fetus | during the postoperative hospital stay | through study completion, an average of 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Late complications for the mother and fetus | during the first 30 days postoperatively | 30 days |