Appendectomy during Pregnancy: A Survey of Two Army Medical Activities

Wittich, Arthur C.; Desantis, Robert A.; Lockrow, Ernest G.

doi:10.1093/milmed/164.10.671

Cited by 23 publications

(7 citation statements)

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“…41 The diagnosis of appendicitis in pregnancy can be difficult clinically because of the displacement of the appendix by an enlarging uterus. This is particularly true in later pregnancy, as evidenced by a perforation rate of 8.7-31% in the first and/or second trimester, rising to 26.1-69% in the third trimester.…”

Section: Suspected Acute Appendicitismentioning

confidence: 99%

Guidelines for Computed Tomography and Magnetic Resonance Imaging Use During Pregnancy and Lactation

Chen¹,

Coakley²,

Kaimal

et al. 2008

Obstetrics &Amp; Gynecology

409

235

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There has been a substantial increase in the use of computed tomography (CT) and magnetic resonance imaging (MRI) in pregnancy and lactation. Among some physicians and patients, however, there are misperceptions regarding risks, safety, and appropriate use of these modalities in pregnancy. We have developed a set of evidence-based guidelines for the use of CT, MRI, and contrast media during pregnancy for selected indications including suspected acute appendicitis, pulmonary embolism, renal colic, trauma, and cephalopelvic disproportion. Ultrasonography is the initial modality of choice for suspected appendicitis, but if the ultrasound examination is negative, MRI or CT can be obtained. Computed tomography should be the initial diagnostic imaging modality for suspected pulmonary embolism. Ultrasonography should be the initial study of choice for suspected renal colic. Ultrasonography can be the initial imaging evaluation for trauma, but CT should be performed if serious injury is suspected. Pelvimetry now is used rarely for suspected cephalopelvic disproportion, but when required, low-dose CT pelvimetry can be performed with minimal risk. Although iodinated contrast seems safe to use in pregnancy, intravenous gadolinium is contraindicated and should be used only when absolutely essential. It seems to be safe to continue breast-feeding immediately after receiving iodinated contrast or gadolinium. Although teratogenesis is not a major concern after exposure to prenatal diagnostic radiation, carcinogenesis is a potential risk. When used appropriately, CT and MRI can be valuable tools in imaging pregnant and lactating women; risks and benefits always should be considered and discussed with patients.

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Section: Suspected Acute Appendicitismentioning

confidence: 99%

Guidelines for Computed Tomography and Magnetic Resonance Imaging Use During Pregnancy and Lactation

Chen¹,

Coakley²,

Kaimal

et al. 2008

Obstetrics &Amp; Gynecology

409

235

View full text Add to dashboard Cite

show abstract

“…common non-obstetrical operations in pregnant patients [1][2][3][4][5]. The highest incidence is appendicitis, which occurs in 0.04-0.2 % of all pregnancies; this representing 25 % of non-obstetric operations performed during pregnancy [1,2,4].…”

mentioning

confidence: 99%

Laparoscopic appendectomy and cholecystectomy versus open: a study in 1999 pregnant patients

et al. 2015

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“…Frequent postoperative complications are uterine contraction, preterm labor and wound infection, while preterm delivery is rare [5,10,13]. Morbidity rate with the non-perforated and the perforated groups are 10% and 35-40%, respectively [27,28]. We found them as 26.1% and 48.6%.…”

Section: Discussionmentioning

confidence: 70%

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

Onder

2012

J Curr Surg

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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 perforation-associated 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 nonperforated 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.

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Appendectomy during Pregnancy: A Survey of Two Army Medical Activities

Cited by 23 publications

References 0 publications

Guidelines for Computed Tomography and Magnetic Resonance Imaging Use During Pregnancy and Lactation

Guidelines for Computed Tomography and Magnetic Resonance Imaging Use During Pregnancy and Lactation

Laparoscopic appendectomy and cholecystectomy versus open: a study in 1999 pregnant patients

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

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