N 2 (199) 2026. P. 98–104

ACUTE ABDOMEN IN PREGNANT WOMEN IN THE THIRD TRIMESTER OF PREGNANCY (WITH CLINICAL CASES)

V. O. Zabolotnov, S. V. Gordiychuk, V. Y. Shatylo, O. O. Khvatova, A. V. Haichenko

Zhytomyr Medical Institute of Zhytomyr Regional Council, Zhytomyr, Ukraine
Ivan Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine, Ternopil, Ukraine

DOI 10.32782/2226-2008-2026-2-14

Acute abdomen during pregnancy is a complex clinical problem that combines a high risk of obstetric complications with the need to differentiate between a wide range of surgical and non-obstetric conditions. The incidence of non-obstetric urgent pathology in pregnant women is low, but it poses a significant threat to the life of the mother and fetus in case of diagnostic delay.

Аim. The aim of this study is to analyze clinical cases of acute abdomen during pregnancy, identifying key diagnostic errors, tactical decisions, and practical conclusions.

Results. The following cases were examined: uterine rupture following conservative myomectomy; spontaneous hemoperitoneum in a full-term pregnancy (SHiP), which required immediate surgical intervention – a cesarean section and subtotal hysterectomy; acute intestinal obstruction at 26 weeks of gestation associated with uterine myoma, uterine inversion, pelvic obstruction, and colonic obstruction; omental appendicitis at 36 weeks of gestation.

Clinical lesson: underestimation of uterine scarring and delay in surgical intervention increase the risk of massive blood loss. Endometriosis may be associated with spontaneous hemoperitoneum during pregnancy (SHiP), which requires immediate surgical intervention. Myomatous nodes can cause atypical urgent symptoms that mimic surgical intestinal pathology. Epiploic appendicitis is a rare but possible cause of acute pain during pregnancy

Clinical cases demonstrate that: atypical course does not exclude catastrophic pathology, a wait-and-see approach in hemodynamic instability is dangerous, and a multidisciplinary approach should be applied at an early stage.

Conclusions. Acute abdomen during pregnancy is a potentially life-threatening condition and a complex multifactorial clinical situation that combines physiologically altered anatomy, modified laboratory parameters, and a high risk of rapid decompensation of the mother and fetus. Delay in diagnosis and surgical intervention is associated with a significant increase in maternal and perinatal morbidity.

Keywords: acute abdomen, third trimester of pregnancy.

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