Acute Appendicitis in Pregnancy: How to Manage?

Overview

Journal Sisli Etfal Hastan Tıp Bul

Specialty General Medicine

Date 2020 Dec 28

PMID 33364887

Citations 4

Authors

Ramazan Kozan

Huseyin Bayhan

Yagmur Soykan

Ahmet Ziya Anadol

Mustafa Sare

Abdulkadir Bulent Aytac

Affiliations

Soon will be listed here.

Abstract

Objectives: Acute appendicitis during pregnancy may be associated with severe maternal and fetal complications. The clinical, laboratory and radiological parameters used in diagnosis and the effects of the surgical method and timing on the results are controversial. The present study aims to reveal the relationship between clinical approach, surgical treatment methods and complications in pregnant women with suspected acute appendicitis.

Methods: Between December 2007 and August 2019, 21 pregnant women who underwent appendectomy were included in this study. Age, gestational age, complaints at admission, leukocyte count, radiological examination results, type of surgery (conventional or laparoscopic), histopathology results, time from admission to operation, maternal and fetal complications were retrospectively evaluated.

Results: The number of patients who developed complications was six (28.6%). Three (14.3%) of these patients had preterm birth and three (14.3%) had an abortion. There was no statistically significant relationship between trimester and complication (p=0.747). Fourteen patients (66.7%) underwent laparoscopic surgery and seven patients (33.3%) underwent conventional surgery. Although the complication rate was higher in the laparoscopic group, there was no statistically significant difference (p=0.306). The fetal loss rate in the series was 14.3% and all were in the laparoscopic group. However, there was no statistically significant difference between the groups (p=0.158).

Conclusion: Pregnancy-related limiting factors may complicate the diagnosis of acute appendicitis. These patients definitely need a more skeptical assessment and additional diagnostic tools beyond the standard clinical approach. Although laparoscopic appendectomy appears to be a safe option in treatment, its relationship with a higher risk of fetal loss should be kept in mind.

Citing Articles

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SAGES guidelines for the use of laparoscopy during pregnancy.

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Rountis A, Dimitroulis D, Nikiteas N Hippokratia. 2023; 26(1):1-6.

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Diagnostic Performance of Magnetic Resonance Imaging for Detection of Acute Appendicitis in Pregnant Women; a Systematic Review and Meta-Analysis.

Motavaselian M, Bayati F, Amani-Beni R, Khalaji A, Haghverdi S, Abdollahi Z Arch Acad Emerg Med. 2022; 10(1):e81.

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Analysis of 190 Female Patients after Appendectomy.

Alotaibi A, Moshref L, Moshref R, Felemban L Obstet Gynecol Int. 2021; 2021:8036970.

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