| Abstract: |
This chapter about surgical problems in the pregnant patient is from a monograph that presents updated information about pregnancy in women with gastrointestinal disorders. The authors note that up to 1 percent of all pregnant women require surgery. As a general rule, the condition of the mother should always take priority because proper treatment of surgical diseases in the mother will usually benefit the fetus as well as the mother. The chapter focuses on bringing readers up to date on the research in the area covered, the recommended treatments, and patient management concerns, notably issues of maternal and fetal safety. The authors first briefly review the various anatomic and physiologic changes that occur during normal pregnancy that can alter the presentation of conditions that require surgery. Separate sections discuss general guidelines for surgery during pregnancy, appendicitis, biliary tract diseases, pancreatitis and gallstone disease, trauma, intestinal obstruction, splenic artery aneurysms, hepatic lesions, hemorrhoids, inflammatory bowel disease, and colorectal malignancy. The authors stress the importance of a clear treatment plan that avoids procrastination, which can be made after careful review of the history, a physical exam performed with the gravid uterus in mind, and judicious use of radiologic studies. Elective procedures can be delayed until after delivery. 45 references. |