Acute appendicitis during pregnancy

Lopez, Hector B.B.; Berendtsen, H; Micheelsen, Ulla

doi:10.3109/01443619409004057

Cited by 3 publications

(3 citation statements)

References 10 publications

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“…The most common clinical presentation is vague pain in the lower right quadrant with rebound tenderness 4,6,12,13,18,21 . In some instances however, especially in the second and third trimesters, the pain may be absent altogether 13 .…”

Section: Clinical Evaluationmentioning

confidence: 99%

“…

Appendicitis in pregnancy 277

because the rate of fetal loss and early delivery in women with perforated appendicitis is substantially higher then cases of simple appendicitis [6][7][8]11,18 .

Curiously, the risk of acute appendicitis is lower in the pregnant than the nonpregnant female population, with the majority of cases in pregnancy occurring in the second trimester 4,9,13,19 . These include: feelings of malaise, nausea/vomiting, constipation/bowel irregularity, urinary frequency, abdominal and pelvic discomfort and leukocytosis 4,7,[9][10][11] .The most common clinical presentation is vague pain in the lower right quadrant with rebound tenderness 4,6,12,13,18,21 . Furthermore, they postulated that this relationship may be linked to the hypothesis of Wegmann et al 20 who thought that the immune system favours humoral immunity mediated by TH2 cells during pregnancy.

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mentioning

confidence: 99%

“…Andersson et al 19 found there to be an inverse relationship between pregnancy and appendicitis. The gravid uterus can cause an upward and deeper displacement of the appendix, pulling it away from the abdominal wall and anterior peritoneal surface; the variable position of the appendix is a major factor that can explain the wide variance in localization and severity of associated pain 4,12,14,21 .Nausea and vomiting are common symptoms of appendicitis, particularly in the second and third trimesters. As a result, TH1 mediated inflammatory responses are weakened, which may account for the lower incidence of appendicitis in pregnancy 20 .…”

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Appendicitis in Pregnancy

Windrim

Czikk

2012

Fet. Matern. Med. Rev.

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Acute appendicitis is the most common non-obstetric indication for surgical intervention in pregnancy, complicating 1/500 to 1/2000 deliveries. Due to the anatomical and physiological changes associated with pregnancy, appendicitis may present a diagnostic dilemma, leading to management delays and thus increasing the risk of appendiceal perforation. Many of the common presenting symptoms of appendicitis are common features of normal pregnancy including lower abdominal pain, nausea, vomiting and leukocytosis. Furthermore, the enlarging gravid uterus may displace the appendix to varying degrees thus altering the classic symptom pattern of appendicitis. The often nonspecific presentation in pregnancy may necessitate the utilization of diagnostic imaging to aid in accurate diagnosis. However, the perforated appendix is the most common surgical cause of fetal loss and the time required for any diagnostic aid must be weighed against the increasing risk of perforation caused by delay in surgical intervention.

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Section: Clinical Evaluationmentioning

confidence: 99%

“…

Appendicitis in pregnancy 277

because the rate of fetal loss and early delivery in women with perforated appendicitis is substantially higher then cases of simple appendicitis [6][7][8]11,18 .

…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Appendicitis in Pregnancy

Windrim

Czikk

2012

Fet. Matern. Med. Rev.

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Case controlled study on diagnostic predictive value of inflammatory markers of complete blood count in pregnant women with acute appendicitis

Erdoğan

2021

Journal of Obstetrics and Gynaecology

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Pregnancies Complicated by Acute Appendicitis

Ngai

1995

Australian and New Zealand Journal of Surgery

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Appendicitis is one of the most common acute abdominal conditions that requires operation during pregnancy. The maternal and fetal complications occurring in such situations are well known. However, the diagnostic and therapeutic challenges of acute appendicitis complicating pregnancy persist in current surgical practice. Thirty-eight obstetric cases who had an appendicetomy performed during pregnancy between 1986 and 1993, were reviewed. In 31 cases, acute appendicitis was proven at laparatomy, and by subsequent histopathology. In the confirmed cases, seven occurred in the first trimester, 12 in the second trimester, eight in the third trimester and four in the immediate postpartum period. Two miscarriages occurred in the first trimester group, and two late abortions and two preterm (26 and 28 weeks) deliveries occurred in the second trimester group. In the third trimester/postpartum group, all babies survived, but four patients had Caesarean sections with the appendicetomy and the incidence of perforatedgangrenous appendices was highest. Perinatal outcome was worst, with the highest fetal wastage rate if the acute appendicitis occurred in the second trimester, although maternal morbidity appeared to be the same across different gestational periods.

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Acute appendicitis during pregnancy

Cited by 3 publications

References 10 publications

Appendicitis in Pregnancy

Appendicitis in Pregnancy

Case controlled study on diagnostic predictive value of inflammatory markers of complete blood count in pregnant women with acute appendicitis

Pregnancies Complicated by Acute Appendicitis

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