With the increase of the month, the small life in the stomach is becoming more and more active. Not only will he "play" with his mother in the evening, greet his father in his unique way, and even divide them at restlessness during the day.When she was four months pregnant, Xiaoyun felt a little painful, which was not the same as before. Sometimes it hurt at night, but after rest, there was nothing abnormal when he got up in the morning, so he let go.Xiaoyun talked to her husband about the matter. Her husband posted his ears on her belly and said, "Wouldn’t it be our child in a hurry?"
Three months later, abdominal pain became more and more aggravated, accompanied by nausea and vomiting.People say that it is three months of joy, but Xiaoyun is still having joy and an aggravated trend.
No one expected that this abdominal pain was not a baby kicking her.One morning, as soon as she got on the car, Xiaoyun felt uncomfortable. She thought it was early.As a result, the pain in the upper abdomen intensified. One or two hours passed was still endless. Xiaoyun was cold and cold, but he couldn’t vomit.It was taken to the hospital and was checked to know that some of the so -called pregnancy reactions were actually caused by appendicitis.The husband asked the doctor puzzled: "I heard that the appendicitis is the right lower abdomen pain, why is my wife’s upper abdomen pain?"
First of all, you must understand a few nouns: fetal movement, physiological abdominal pain during pregnancy, pathological abdominal pain during pregnancy.
Refers to the activity of the body or limbs that pregnant women can feel in the uterine cavity.Generally, you can feel fetal movement from 18 to 20 weeks of pregnancy.With the increase of the gestational week, the intensity of fetal movement gradually increased, and the number of times increased.From 29 to 38 weeks of pregnancy, the frequency of fetal movement reaches the peak, and it will decrease later.
The number of normal fetal movements and strengths have a certain regularity.Because the number of fetal movements, fast and slow weakness, etc. are closely related to the fetal safety, if pregnant women can master the method of calculating fetal movement, it will help self -monitoring.
In the fixed time in the morning, middle and evening, the pregnant woman counts the fetal movement for 1 hour, and the three additional additions and 4 are 12 hours of fetal movement.Normal fetal movement is not less than 3 times, and the number of fetal movements in 12 hours is not less than 30 times.If the number of fetal movements on the day decreases by 30%or more than the previous day, it is a reduction in fetal movement.Such as: insufficient placental function, some diseases in the fetus, or some chronic diseases before the fetus dying in the fetus, fetal movement often decreases.The violent fetal movement often indicates that the fetus is hypoxic. If it is not treated in time, the tragedy in the fetus is likely to occur.Once pregnant women who were pregnant at 18 weeks, they should go to the hospital immediately if they found abnormal fetal movements to ensure the safety of maternal and infants.
Xiaoyun in the above is not enough to grasp the laws and time of fetal movement. When the law of fetal movement changes, it does not cause enough attention. Go to the hospital as soon as possible to find the problem.
Physiological abdominal pain during pregnancy
This is a common situation.Normal pregnancy increases, and the uterine round ligament is excessively pulled, which may cause pain.It is more common at 3 to 5 months of pregnancy. The pain are mostly located on the side or multi -side side of the lower abdomen.It appears, which can be relieved after bed.
In addition, the fetus kicking in the mother’s abdomen causes mothers’ discomfort can also cause physiological abdominal pain. It is also seen during the night rest of the pregnancy, which causes lower abdomen pain due to the shrinkage of pseudo -uterine contraction.These pains have a characteristic, which is to alleviate after bed or change.Xiaoyun’s early pregnancy abdominal pain is largely belonging to this physiological abdominal pain.
Anyone who is inconsistent with the regular rhythm of normal physiological abdominal pain, and those who cannot be relieved after a rest or change position can be summarized to the category of pathological abdominal pain.
Pathological abdominal pain during pregnancy
There are many cases, including acute appendicitis, hydatidal, abortion, premature birth, etc.It should be noted that acute appendicitis is often the most common abdominal surgery of non -production indications during pregnancy.
According to domestic medical data, 80%of patients with pregnancy appendicitis developed on the disease within 3 months of pregnancy, and the mortality rate of pregnant women reached 2%;Abortion and premature birth) are about 2%to 20%.These are determined by the pathological characteristics of appendicitis during pregnancy:
During pregnancy, pelvic blood vessels increase, appendix congestion, inflammation develops rapidly, and prone to necrosis and perforation; large omentum is pushed by uterine, which is difficult to surround the inflammation. Once the appendix is perforated, it can easily cause diffuse peritonitis;Movies may induce uterine contraction, cause abortion, premature birth, and dying of fetal hypoxia.
Pregnant women have different appendicitis and different people. It is prone to misdiagnosis, accidental treatment or delay treatment, which seriously threatens the safety of pregnant women and fetuses.
Most of patients with appendicitis in pregnancy are pain in the right upper abdomen, and do not have a right lower abdomen pain like ordinary people, because the uterus continues to increase with the pregnancy age and push the appendix up.However, there are also a few patients because they are young, their uterus is not large, or the cecum is relatively fixed, which still manifests in pain in the right lower abdomen.
In addition to abdominal pain, some patients may have symptoms such as vomiting, mild diarrhea, fever, and increased blood cells.Xiaoyun has nausea, vomiting, gastrointestinal discomfort, etc. in the late pregnancy. These are often similar to their own physiological changes, so they fail to attract the attention of the couple.In addition, if a blood test is performed, and because the white blood cells in the pregnant woman are more than ordinary people, they will interfere with the correct judgment of the doctor.
As mentioned above, the disease is more difficult to diagnose, so doctors need to show twelve martial arts to identify.Doctors often use the following two tests to help diagnosis:
The first is the Bryan test.Let the patient take the right side position and move the uterine to the right to cause pain. It is indicated that pain comes from non -uterine organs and can be used as a reliable signs that distinguish acute appendicitis and uterine diseases during pregnancy.
The second is the Alder test.Press your fingers where the tenderness is the most obvious, and then change to the left side position to move the uterus towards the left.If the tenderness is reduced or disappeared, it is prompted that the source of the disease may be in the uterus or attachment; if the tenderness continues to exist, it is prompted to be in the appendix.
When doing these two experiments, pregnant women will be more painful, but in order to clarify the diagnosis, it is worth it to temporarily endure these pain and discomfort.
If you want to hold the tricky appendix, you also need to perform some imaging examinations.In order to avoid ionizing radiation, MRI is more suitable than CT scanning, and fast MRI is more suitable than conventional MRI because the former exposure time.The necessary B -ultrasound and blood routine biochemical examinations are also indispensable.
When the doctor proposed to use surgery to remove the appendix immediately, the Xiaoyun family was worried that anesthesia and surgery would have an impact on pregnant women and fetuses.
The treatment principle of appendicitis during pregnancy is surgery as soon as possible, supplemented by proper drug treatment.The concept of "medicine affects fetuses" has caused many prospective parents to suffer from serious "pharmaceuticals".The placental barrier has limited effects. Some drugs are harmful to the fetus, especially in the early stages of pregnancy, but it is not so terrible to take medicine under the guidance of a doctor.In addition, if no early surgery is not surgery, once the time is delayed to the appendix rupture, the acute peritonitis will cause the pregnant woman to be sepsis. At that time, the mother and the fetus will be in danger of life.
Depending on the differences in the early and late stages of pregnancy, there are certain differences in the treatment measures for pregnancy and acute appendicitis.
1. Early pregnancy (1 to 12 weeks)
Regardless of its clinical manifestations, surgery should be surgical.At this time, the surgery is not much interfered for uterine and will not affect continuing pregnancy.When performing surgery in the abdomen, ensure the relaxation of the abdominal muscles to reduce the stimulation of the uterus; give timely a natural progesterone preparation that suppress the uterine contraction after surgery, and do a good job of psychological treatment to relieve the mental burden as much as possible.
2. In the middle of pregnancy (13-28 weeks)
The placenta has gradually formed, the uterus has left the pelvic cavity, and the abdominal cavity is developed; although the uterus has increased, the pelvic abdominal cavity still has enough operating space;It is not easy to have a miscarriage and can continue pregnancy.In the middle of pregnancy, the best period of appendix resection surgery.
3. Late pregnancy (28-36 weeks)
The uterus has increased significantly. At 32 weeks of pregnancy, the height of the uterine bottom is already between the umbilicus and the sword, and the fetus is relatively mature.At this time, the relevant surgical treatment is performed, and most babies can survive even due to surgical stimulation.Surgery has little impact on pregnant women.If the pregnancy is nearly due, considering the relatively difficult operation of the pelvic abdominal surgery, a cesarean section can be used first, and the appendix resection surgery can be performed.