Acute Appendicits in Pregnancy: Evaluation of 129 Patients During 20 years

Abstract

Background: Acute appendicitis is the most common non-obstetric emergency requiring surgery during pregnancy, and delayed diagnosis is associated with a greater risk of fetal or maternal morbidity and fetal loss. The aim of this study is to analyze the diagnosis of acute appendicitis during pregnancy, along with maternal and fetal complications.

Methods: Between January 1990 and December 2010, 129 pregnant women who were operated on due to acute appendicitis were evaluated retrospectively.

Results: The mean age of patients was 28.3 6.6 years, and the time from presentation of symptoms to admission was 41.1 33.2 hours. The most common complaints were lower right quadrant pain (66.7%) and nausea-vomiting (65.1%). The most common physical signs were abdominal tenderness and rebound. Gestational stage at diagnosis was second trimester in 74 patients, first trimester in 31 patients, and third trimester in 24 patients. The perforation rate among our cases was 28.7%. The perforationassociated with delayed admission to the hospital (P = 0.001) was the most common in the first trimester with a rate of 40.5%. Morbidity occurred in 41 patients (31.8%). Fetal mortality occurred in 1 (1.1%) of non-perforated patients, and in 5 of the perforated patients (13.5%). No maternal mortality occurred. Mean hospital stay was 2.8 0.9 days in non-perforated patients, while 5.3 2.2 days in perforated patients (P = 0.001).

Conclusions: Because of the nonspecific and pregnancy-attributed symptoms, acute appendicitis during pregnancy may result in an increased risk of fetomaternal morbidity and fetal mortality.




doi:10.4021/jcs17w