Appendicitis in pregnancy, Diagnosis, management and complications

Abstract

Appendicitis in pregnancy should be suspected when a pregnant woman complains of new abdominal pain. No laboratory finding was found to be diagnostic for acute appendicitis during pregnancy. Considerable fetal loss was found after appendectomy during pregnancy in the first and second trimester. No increase in pregnancy complications in cases with perforated appendicitis was observed. The combination of symptoms and clinical judgement is still vital in deciding which patient needs surgical treatment. Based on the results in the present study we recommend prophylactic antibiotic treatment in all laparotomies during pregnancy when appendicitis is suspected.

Acute appendicitis during pregnancy: Case series of 20 pregnant women

“…[1,2] Diagnosis of appendicitis during pregnancy remains challenging. Physiological mild leukocytosis seen in pregnant women, change in location of appendix and low sensitivity rates of ultrasound (US) imaging cause …”

MRI for Suspected Appendicitis in Pregnancy

“…Ultrasound is usually the first step of image modalities. However, ultrasound highly depends on operators' experience, and will be interfered by intestinal gas and enlarged uterus [7][8][9]. Computer tomography will not be taken into consideration because of radiation exposure, although present guidelines ensure fetal safety with exposure dose less than 5 rads [10,11].…”

Dilemma of Acute Appendicitis

“…Active observation' is reasonable, safe and effective in early appendicitis, if peritonism is absent and the diagnosis uncertain. It permits differentiation between patients with persistent or progressive signs requiring surgery and those with nonspecific pain or alternative pathology [3,28]. Deliberate delay allows time for the results of appropriate investigations to be reviewed and it is extremely rare for such an appendix to rupture during observation and the diagnosis will usually become apparent within 12-24 hours [29].…”