Table 4.

Key practice points

AAP – key practice points
1. AAP requires a systematic diagnostic and therapeutic approach
2. It can be broadly classified into pregnancy-related and non-pregnancy-related causes
3. The gravid uterus can displace adjacent viscera and stretch the abdominal wall, thereby altering classical clinical findings
4. Physiological changes such as leukocytosis and physiological and other biochemical parameters can interfere with the interpretation of laboratory results
5. Acute appendicitis is the commonest non-obstetric cause
6. There is insufficient evidence to recommend a conservative approach for acute appendicitis in pregnancy
7. Potentially life-threatening obstetric causes include ruptured ectopic pregnancy, abruption, and uterine rupture
8. Ultrasonography is the first imaging modality of choice
9. MRI without gadolinium can be considered as a second line of imaging
10. In indicated cases, X-ray and CT scan with contrast can be performed safely without significant risk of fetal harm after appropriate counseling
11. The Kleihauer–Betke test should be performed in all cases of major trauma
12. Multidisciplinary consultations involving the surgeon, radiologist, and critical care physician should be practiced
13. When in doubt, surgical intervention should not be delayed
14. Open surgical intervention is the traditional approach
15. Laparoscopic surgery is safe and feasible in select situations

Abbreviations: AAP, acute abdomen in pregnancy; CT, computed tomography; MRI, magnetic resonance imaging.