JCOGP
Journal of Controversies in Obstetrics & Gynecology and Pediatrics

As of January 2023, our "Journal of Controversies Obstetrics & Gynecology and Pediatrics" has been published under the Medihealth Academy to publish all articles, reviews and case reports on Pediatrics, especially in the field of Obstetrics and Gynecology. In order to facilitate the citation of the articles, to take our place in internationally respected indexes and to reach a wider readership, we will pay attention to the fact that our article language is only English in terms of acceptance.

eISSN: 2980-0579
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
Acute abdomen in pregnancy in tertiary referral center: diagnostic challenges and surgical outcomes
Abstract
Aims: Acute abdomen during pregnancy is a challenging clinical condition requiring prompt diagnosis and management to prevent adverse maternal and fetal outcomes. This study aimed to evaluate the clinical characteristics, diagnostic approaches, and surgical outcomes of pregnant patients presenting with acute abdomen.
Methods: This single-center retrospective study included 13 pregnant patients diagnosed with acute abdomen who underwent surgical intervention (laparotomy or laparoscopy) between October 2025 and January 2026. Demographic, clinical, laboratory, imaging, surgical, and obstetric outcomes were analyzed. Statistical analyses were performed using non-parametric tests, and correlations were assessed using Spearman’s method.
Results: The median maternal age was 29 years, and the median gestational age at admission was 24 weeks. The most common diagnosis was ovarian torsion (53.8%), followed by less frequent conditions including appendicitis and other etiologies. Ultrasound was used in all patients, while magnetic resonance imaging was performed in selected cases (15.4%). Laparotomy was the predominant surgical approach (92.3%). Maternal and neonatal outcomes were generally favorable, with a median delivery at 37 weeks and a low rate of neonatal intensive care unit admission (15.4%). A significant association was observed between trimester and pain duration (p=0.027). Additionally, a strong negative correlation was found between gestational age at admission and the interval from diagnosis to delivery (rho = -0.97, p < 0.001).
Conclusion: Acute abdomen in pregnancy requires timely diagnosis and a multidisciplinary approach. Gynecological causes, particularly ovarian torsion, may predominate in surgically managed cases. Early intervention is associated with favorable maternal and neonatal outcomes.

Keywords : Acute abdomen, pregnancy, adnexal torsion, ultrasonography, magnetic resonance imaging

Download Article
Ethical Statement

This study was approved by the Scientific Researches Evaluation and Ethics Committee of Ankara Etlik City Hospital (Date: 17.02.2026, Decision No: AEŞH BADEK2-2026-160).

Informed Consent

Written informed consent was obtained from all individual participants prior to their inclusion in the study. Participants were fully informed about the study’s aims, procedures, potential risks and benefits, and their rights—including the right to withdraw at any time without consequence. All participants voluntarily signed a written informed consent form.

Author Contributions

Concept: NÇK, ATÇ; Design: NÇK, ZŞ, ATÇ; Control: ATÇ; Data Collection and/or Processing: NÇK, ZŞ, ÜÖ, DDB; Analysis and/or Interpretation: NÇK, DDB, ATÇ; Literature Review: NÇK; Article Writing: NÇK; Critical Review: NÇK, ZŞ, ÜÖ, ATÇ.

Conflict of Interest

The authors declare no conflicts of interest related to this study.

Financial Disclosure

The authors received no financial support for the conduct or publication of this research.


1. Andronic O, Stanescu L, Talpai T, et al. Surgical emergencies in pregnancy: a retrospective analysis of six surgical departments and review of the literature. Chirurgia (Bucur). 2025;120(2):193-204. doi:10.21614/chirurgia.3024
2. Rathore N, Tripathi V, Dixit N. ANC with acute abdomen: a case report from a secondary care hospital in Western Maharashtra. Int J Reprod Contracept Obstet Gynecol. 2023;12(10):3073-3075. doi:10.18203/2320-1770.ijrcog20233317
3. Dhamecha R, Pajai S, Bhasin T. Acute abdomen in pregnancy: a comprehensive review of diagnosis and management. Cureus. 2023;15: e40679. doi:10.7759/cureus.40679
4. Zachariah S, Fenn M, Jacob K, Arthungal S, Zachariah S. Management of acute abdomen in pregnancy: current perspectives. Int J Womens Health. 2019;11:119-134. doi:10.2147/IJWH.S151501
5. Abhirami G, Sathyavani C, Patil R. Acute abdomen in pregnancy: a case series on clinical presentation and diagnostic dilemma. Int J Reprod Contracept Obstet Gynecol. 2021;10(3):1162-1165. doi:10.18203/2320-1770.ijrcog20210336
6. Mantoo A, Hamid U, Meshram A, Mantoo S. Identifying and managing obstetric emergencies in non-obstetric setup. J Popul Ther Clin Pharmacol. 2025;32(5):1027-1035. doi:10.53555/tzev0540
7. Chwat C, Terres M, Duarte M, et al. Laparoscopic treatment for appendicitis during pregnancy: retrospective cohort study. Ann Med Surg (Lond). 2021;68:102668. doi:10.1016/j.amsu.2021.102668
8. Zechiu I, Ciobanu A, Gica C, et al. Acute appendicitis in pregnancy. Rom Med J. 2022;69(Suppl 2):11-15. doi:10.37897/rmj.2022.s2.2
9. Börner N, Kappenberger A, Weber S, Scholz F, Kazmierczak P, Werner J. The acute abdomen: structured diagnosis and treatment. Dtsch Arztebl Int. 2025;122(5):137-144. doi:10.3238/arztebl.m2025.0019
10. Unal A, Sayharman S, Ozel L, et al. Acute abdomen in pregnancy requiring surgical management: a 20-case series. Eur J Obstet Gynecol Reprod Biol. 2011;159(1):87-90. doi:10.1016/j.ejogrb.2011.07.028
11. Choi Y, Seo J, Yi J, Choe Y, Heo Y, Choi S. Clinical characteristics of acute appendicitis in pregnancy: 10-year experience at a single institution in South Korea. J Clin Med. 2023;12(9):3277. doi:10.3390/jcm12093277
12. Lochmanová I, Zapletal J, Sehnal B, Waldauf P, Oliverius M. Acute appendicitis in pregnancy: a single-center retrospective cohort study. Visc Med. 2026;42(1):1-6. doi:10.1159/000545862
13. Samuel J, Nrarta I. Perioperative anesthetic care for laparoscopic appendectomy in a pregnant woman: a case report. Int J Res Rev. 2025; 12(6):401-404. doi:10.52403/ijrr.20250647
14. Hassan RA, Ali IA, Elmi AH, Omar A. Conservative treatment of third trimester appendicitis misdiagnosed as round ligament pain: a case report and review of the literature in a resource-limited setting. Int J Womens Health. 2025;17:2413-2420. doi:10.2147/IJWH.S53639
15. Yavuz Y, Sentürk M, Gümüş T, Patmano M. Acute appendicitis in pregnancy. Ulus Travma Acil Cerrahi Derg. 2021;27(1):85-88. doi:10.14744/tjtes.2020.22792
16. Chaudhary W, Ahsan M, Hashim M, et al. Diagnosis of acute appendicitis: ultrasound as first-line imaging modality. Pak J Health Sci. 2022;3(5):3-7. doi:10.54393/pjhs.v3i05.220
17. Ahmed B, Williams JS, Gourash W, et al. MRI as first line imaging for suspected acute appendicitis during pregnancy: diagnostic accuracy and level of inter-radiologist agreement. Curr Probl Diagn Radiol. 2022; 51(4):503-510. doi:10.1067/j.cpradiol.2021.09.001
18. Lee JH, Choi J, Kim Y. Safety of laparoscopic surgery during pregnancy: a Korean nationwide population-based study. Surg Endosc. 2022;36: 7529-7540. doi:10.1007/s00464-022-09188-9
19. Giannini A, Cuccu I, D’Augè TG, et al. The great debate: surgical outcomes of laparoscopic versus laparotomic myomectomy. A meta-analysis to critically evaluate current evidence and look over the horizon. Eur J Obstet Gynecol Reprod Biol. 2024;297:50-58. doi:10.1016/j.ejogrb.2024.03.045
20. Zhang Z, Zhang Y, Fu H, Guo R. Laparotomy versus laparoscopy for the treatment of adnexal torsion during pregnancy. BMC Pregnancy Childbirth. 2024;24(1):714. doi:10.1186/s12884-024-06898-x
21. Özdemir A, Tarim I, Derebey M, Küllaç F, Barutcu B, Köse B. Comparison of maternal and fetal outcomes of laparoscopic versus open appendectomy in pregnancy. Medicine (Baltimore). 2025;104(38): e44546. doi:10.1097/MD.0000000000044546
22. Tawashi K, Tawashi Y, Jomaa S, Alabdallah E, Al-Hussien M, Ammar A. The management of torsion of huge pedunculated fibroid in 19 weeks pregnant in a low-income country: a case report. Int J Surg Open. 2023. doi:10.1016/j.ijso.2023.100676
23. Crum JM, Levitin H. Heterotopic pregnancy: a difficult and rarely considered diagnosis. Cureus. 2023;15(3):e36749. doi:10.7759/cureus.36749
Article available in :
Volume 4, Issue 4, 2026
Page : 102-107
https://doi.org/10.51271/JCOGP-0082
Article Information
Received : 26 Tem 2026
Accepted : 20 Eki 2026
Published : 28 Eki 2026
Corresponding Author :

Neval Çayönü Kahraman: Department of Perinatology, Ankara Etlik City Hospital, Ankara, Turkiye

[email protected]
Citation : Çayönü Kahraman N, Şeyhanlı Z, Özcan Ü, Duygulu Bulan D, Çağlar AT. Acute abdomen in pregnancy in a tertiary referral center: diagnostic challenges and surgical outcomes. J Controv Obstetr Gynecol Ped. 2026;4(4):102-107. doi:10.51271/JCOGP-0082

Read: 2
Download : 9
Cited: 0
_Footer