Acute appendicitis in pregnancy; A single center experience

Appendicitis in Pregnancy

Abstract

Objective

Appendicitis is the most common cause of extrauterine acute abdomen during pregnancy. There are scoring systems, such as Alvarado, based on physical examination and laboratory values developed for the diagnosis of appendicitis in the general population. However, when it comes to pregnant women, the effectiveness of the methods used in daily practice decreases considerably. In our study, we aimed to share the data of our patients who were diagnosed with acute appendicitis during pregnancy in our clinic.

Material methods

Pregnant women who were operated for acute appendicitis between April 2008 and May 2021 were included in the study. Demographic data of the patients, gestational week, physical examination and laboratory values at the time of admission, USG findings, type of surgery performed, surgical findings, pathology results and fetal-maternal complications that developed during postoperative follow -up were reviewed retrospectively through the hospital system.

Results

From the clinicopathological features of the patients, only re-operation due to appendiceal stump leakage (p:0.04) and drain placement during operation (p:0.046) were significantly associated with miscarriage. Although complications and abortion rates were higher in patients with perforation and periappendicular abscess, the difference was not statistically significant.

Conclusion

Detailed history and physical examination are key for the diagnosis of acute appendicitis in pregnant women. Any patient with right lower quadrant pain, nausea, vomiting and fever, who has tenderness and defensive rebound in the right lower quadrant on physical examination should be considered as appendicitis after obstetric causes are excluded, until proven otherwise.