Laparoscopic Treatment for Appendicitis During Pregnancy: Retrospective Cohort Study

Overview

Journal Ann Med Surg (Lond)

Publisher Wolters Kluwer

Specialty Medical Education

Date 2021 Aug 19

PMID 34408866

Citations 1

Authors

Carina Chwat

Marcelo Terres

Mauro Ramirez Duarte

Diego Valli

Flavia Alexandre

Guillermo Rosato

Gustavo Lemme

Affiliations

Soon will be listed here.

Abstract

Background: Acute appendicitis is the most frequent non-obstetric surgical emergency during pregnancy. The benefits of laparoscopy during pregnancy are well known, but complications can occur, and these can affect both the mother and/or the foetus.We present results of laparoscopic surgical treatment of acute appendicitis in pregnant women, analysing the occurrence of adverse postoperative, obstetric and foetal outcomes and reviewing literature.

Materials And Methods: Retrospective observational study on pregnant women with a preoperative diagnosis of acute appendicitis.

Results: n = 63, mean age 28.4 years, average gestational age of 17.7 weeks (3-30 weeks). 6.4 % exploratory laparoscopies, 92 % laparoscopic appendectomies and one right colectomy were performed. Conversion rate was 3.2 %. When symptoms begun within 48 hours prior to surgery, a perforated appendicitis was found in 11 %; whereas when the time from symptom onset to surgery was greater than or equal to 48 hours, it was evident in 31 % of the cases (p 0.008). The only independent variable associated with the presence of postoperative complications was symptom duration prior to surgery greater than or equal to 48 hours (OR 4.8; 95 % CI 1.1-16.2; p 0.04). Seven minor and 2 mayor postoperative complications were observed. Patients with complications spent, on average, twice as many days hospitalized (p < 0.001); and had 8 times more risk of preterm delivery (p 0.03). Obstetric complications were more frequent in pregnant women operated during the first trimester. Foetal mortality was 1.6 %.

Conclusion: Surgical morbidity of acute appendicitis in pregnant women is linked to the delay in the diagnosis and treatment of the inflammatory condition. Laparoscopic appendectomy during pregnancy is not exempt from postoperative, obstetric and foetal complications. It is necessary to standardize the definitions of "complication" in order to collate reliably the outcomes presented in the literature.

Citing Articles

Fetal biometric and Doppler measurements following abdominal radical trachelectomy in the second trimester of the pregnancy.

Shima E, Itsukaichi M, Yoshihara K, Ishiguro T, Haino K, Nishino K BMC Pregnancy Childbirth. 2022; 22(1):343.

PMID: 35443666 PMC: 9022245. DOI: 10.1186/s12884-022-04671-6.

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