Appendicitis in Pregnancy: Presentation, Management and Complications

Davoodabadi, Abdoulhossein; Davoodabadi, Hassan; Akbari, Hossein; Janzamini, Monireh

doi:10.17795/zjrms-7557

Cited by 7 publications

(6 citation statements)

References 29 publications

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“…Similar to what has been reported in the literature, most of our patients were in the second trimester [ 13 ]. However, Davoodabadi et al [ 14 ] found that the incidence of acute appendicitis during pregnancy was high during the third trimester. The second trimester is considered as the most appropriate time for appendectomy and this period has the lowest risk for fetus from operation and anesthesia.…”

Section: Discussionmentioning

confidence: 99%

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Acute Appendicitis in Pregnancy and the Developing World

Bhandari

Shahi

Acharya

2017

International Scholarly Research Notices

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Background Acute appendicitis is the commonest nonobstetric surgical emergency during pregnancy. The aim of the study was to compare perioperative outcomes of acute appendicitis in pregnant and nonpregnant patients. Methods A retrospective review of medical records of 56 pregnant patients between 2011 and 2016 who were compared with 164 nonpregnant women of reproductive age who underwent open appendectomy between 2014 and 2016 for acute appendicitis. The patient's demographics and perioperative data were analyzed. Results The median age of pregnant and nonpregnant patients observed was 26 years (range 19–37) and 26 years (range 18–43). There were no significant differences between the groups in negative appendectomy (21.4 and 21.3%, P = 0.52), perforated appendicitis (25 and 23.8%, P = 0.85), postoperative complications (28.6 and 26.8%, P = 0.80), and median length of hospital stay (5 and 4.5 days, P = 0.36). There were 3.6% preterm labour, no maternal mortality, and no fetal loss. In multivariate analysis, WBC >18000/mm3 and long patient time to surgery were independent risk factors for appendicular perforation and postoperative complication (P < 0.05). Conclusion Our results of appendectomy in pregnant patients are comparable with nonpregnant patients. Hence the same perioperative treatment protocol can be followed in pregnant and nonpregnant patients even in resource-poor setting.

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Section: Discussionmentioning

confidence: 99%

“…In the second month of gestation, the neutrophil count starts to increase and plateaus in the second or third trimester. During that time the total leucocyte counts range from 10000 to 15,000/mm 3 [ 14 ]. The current study reported 62.5% of abnormal leukocyte count which is in concordance with what was reported by Hiersch et al [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Acute Appendicitis in Pregnancy and the Developing World

Bhandari

Shahi

Acharya

2017

International Scholarly Research Notices

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“…To decrease negative appendectomy, and postoperative complication "accurate and timely diagnosis are needed" 15,25 and perforated appendicitis in most of the patients 26 , is a result of delayed consultation, additional ultrasonography or CT scan of the abdomen can be performed in order not to operate hastily, albeit it is recommended to monitor changes in symptoms a little longer 27 , with retaking precise symptoms and signs catlike observation of 12 ± 8 hours could be sufficient to make surgical decisions, "Despite a high negative appendectomy" 17,28 .…”

Section: Discussionmentioning

confidence: 99%

A five-year longitudinal observational study in morbidity and mortality of negative appendectomy in Sulaimani teaching Hospital/Kurdistan Region/Iraq

Ahmed

Muhedin

Boujan

et al. 2020

Sci Rep

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The most common surgical emergency is suspected acute appendicitis, the lifetime risk of acute appendicitis is estimated to be 8.6% for men and 6.7% for women, with a male to female ratio of 1.4:1; correct diagnosis can be made in 70-80% of patients after the operations about 32% of appendectomies revealed normal appendices and meanwhile appendectomy has a considerable morbidity and mortality. The aim is to explore potential morbidity and mortality associated with negative appendectomy. Prospective case series study, including 5847 patients, who were suspected to have acute appendicitis over a period of five years from 1st December 2013 to 30th November 2018, in emergency department of Sulaimani Teaching Hospital. All the collected data were collected, organized then analyzed by Statistical Package for the Social Sciences version 21. Morbidity in the patients with negative appendectomies occurred in patients in the form of 90 (01.91%) wound infection, 48 (01.02%) intestinal obstruction and last 15 (00.32%) patients developed septicemia. While mortality in negative appendectomy patients was 21, (00.45%). Negative appendectomies have high rates of morbidity and mortality, knowing real rates may help in considering various policies and may be helpful to elude avoidable complications and potential mortality. Non traumatic acute abdomen is 4-8% of adults admitted to the emergency department 1,2. The most common surgical emergency is suspected acute appendicitis, "the lifetime risk of acute appendicitis is estimated to be 8.6% for men and 6.7% for women" 3. Males are affected one and half more times than females 4 while definite diagnosis could be done in 70-80% of patients 1 , after the operations about 32% of appendectomies revealed normal appendices 5 , In females of child bearing age, gynecological pathologies are simulating acute appendicitis 1 , which may increase the prevalence of negative appendectomies. Clinical suspicion of acute appendicitis is mostly done on patient's symptoms and physical findings, including Alvarado score "which has adding accuracy (98.60%) versus computerized tomography (CT) scan (99.03%) 6. Although laboratory blood and urine investigations and simple imaging like plain erect abdominal radiogram and ultrasonography of abdomen and pelvis may aid in accuracy of the diagnosis. "But are not as helpful as magnetic resonance imaging (MRI) and CT scan, which have accuracy of 98% in diagnosing acute appendicitis and lastly diagnostic laparoscopy" 1,3,7-10 .

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“…Literature review of the 14 published studies (n=98.933) comparing pregnant (n=3.971) and non-pregnant AAp (n=94.962) reveal that NA rates of pregnant women vary from 0% to 38% whereas NA rates of non-pregnant women vary from 0% to 21.8%. [4,5,[9][10][11][12][13][14][15][16][17][18][19][20] In eight of these studies, NA was found to be higher in pregnant patients, whereas in three of these studies, NA was found to be higher in non-pregnant. Although it was not statistically significant, NA rates of pregnants were higher in the study we present (26.0 vs. 20.8%).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Demographic and Clinical Features of Pregnant and Non-pregnant Patients Undergoing Appendectomy

Koç

Akbulut

Coşkun

et al. 2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: This retrospective study aims to compare the demographic and clinicopathological characteristics of the pregnant and non-pregnant patients who underwent appendectomy with a presumed diagnosis of acute appendicitis. METHODS:Between June 2009 and January 2019, 431 reproductive-aged of female patients underwent appendectomy with a presumed diagnosis of acute appendicitis. Patients were divided into two groups considering their pregnancy status: pregnant group (n=48) and non-pregnant group (n=383). Both groups were compared with respect to demographic, clinical and histopathological features. RESULTS:No statistically significant difference was found between pregnant and non-pregnant groups except total bilirubin level (p=0.019) and ultrasonographic findings (p=0.016). In the non-pregnant group, negative appendectomy and perforation rates were 26% and 10.5%, where these rates for the pregnant group were 20.8% and 4.2%. Sensitivity, specificity and accuracy rates of ultrasonography for the pregnant group were 50%, 100% and 58.5%, where these rates for the non-pregnant group were 67.3%, 57.9% and 65%. The pregnancy date was the first trimester in 52.1%, the second trimester in 29.2% and the third trimester in 16.7% of the pregnants. None of the term births (87.5%) resulted in neither a fetal nor a maternal complication. However, 12.5% of the preterm births resulted in neonatal mortality. CONCLUSION:Although not statistically significant, this study points out relatively lower rates of negative appendectomy and perforated acute appendicitis among pregnant patients, which is related to the overly attentive evaluation of pregnants admitted due to acute abdomen.

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Appendicitis in Pregnancy: Presentation, Management and Complications

Cited by 7 publications

References 29 publications

Acute Appendicitis in Pregnancy and the Developing World

Acute Appendicitis in Pregnancy and the Developing World

A five-year longitudinal observational study in morbidity and mortality of negative appendectomy in Sulaimani teaching Hospital/Kurdistan Region/Iraq

Comparison of Demographic and Clinical Features of Pregnant and Non-pregnant Patients Undergoing Appendectomy

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