Perforated peptic ulcer in pregnancy and puerperium: A systematic review  

作　　者：Goran Augustin Jure Krstulović Ante Tavra Zrinka Hrgović 

机构地区：[1]Department of Surgery,University Hospital Centre Zagreb,Zagreb 10000,Croatia [2]Department of Surgery,University Hospital of Split,Split 21000,Croatia [3]University of Split School of Medicine,Split 21000,Croatia

出　　处：《World Journal of Gastrointestinal Surgery》2025年第4期360-368,共9页世界胃肠外科杂志(英文)

摘　　要：BACKGROUND Peptic ulcer disease(PUD)during pregnancy is extremely rare.Perforated peptic ulcer(PPU)during pregnancy has high maternal and fetal mortality.Symptoms attributed to pregnancy and other diagnoses make the diagnosis of preoperative PPU during pregnancy and puerperium challenging.AIM To identify predictive factors for early diagnosis and treatment,and the association between the diagnosis and maternal/neonatal outcomes.METHODS We searched PubMed,PubMed Central,and Google Scholar.Articles were analyzed following preferred reporting items for systematic reviews and metaanalysis.The search items included:‘ulcer’,‘PUD’,‘pregnancy’,‘puerperium’,‘postpartum’,‘gravid’,‘labor’,‘perforated ulcer’,‘stomach ulcer’,‘duodenal ulcer’,‘peptic ulcer’.Additional studies were extracted by reviewing reference lists of retrieved studies.We included all available full-text cases and case series.Demographic,clinical,obstetric,diagnostic and treatment parameters,and outcomes were collected.RESULTS Forty-three cases were collected.The mean maternal age was 30.9 years;36.6%were multiparous,and 63.4%were nulliparous or primiparous,with multiparas being older than primiparas.Peptic ulcer perforated in 44.2%of postpartum and 55.8%of antepartum patients.Antepartum PPU incidence increased with advancing gestation 2.3%in the first,7%in the second,and 46.5%in the third trimester.The most common clinical findings were abdominal tenderness(72.1%),rigidity(34.9%),and distension(48.8%).Duodenal ulcer predominated(76.7%).In 79.5%,the time from delivery to surgery or vice versa was>24 hours.The maternal mortality during the third trimester and postpartum was 10%and 31.6%,respectively.The trimester of presentation did not influence maternal mortality.The fetal mortality was 34.8%,with all deaths in gestational weeks 24-32.CONCLUSION Almost all patients with PPU in pregnancy or puerperium presented during the third trimester or the first 8 days postpartum.Early intervention reduced fetal mortality bu

关 键 词：Peptic ulcer disease Perforated peptic ulcer PREGNANCY PUERPERIUM OUTCOMES Systematic review 

分 类 号：R57[医药卫生—消化系统]