Appendicitis in Pregnancy

Abstract

Background: Our urban practice had two incidences of documented appendicitis in pregnancy in a 24-hour period with two unique outcomes that prompted an inquiry. Appendicitis in pregnancy is relatively rare, but it has significant morbidity and is a cause of maternal and infant mortality. Abdominal pain is the most common presenting symptom, and the consideration of multiple pathologic disorders should be entertained. Accurate diagnosis of appendicitis in pregnancy is the largest challenge since the signs and symptoms may vary depending on the trimester in which the patient presents.Methods: We undertook a systematic review of English-language articles from 1975 to 2005 using the key words "appendicitis," and "pregnancy" using MEDLINE, CINAHL, and Cochrane Controlled Trials Register databases.Results and

Acute Appendicitis – Propedeutics and Diagnosis

“…Gynaecologic and obstetric conditions include ovarian cyst, adnexal torsion, salpingitis, abruptio placenta, chorioamnionitis, degenerative fibroid, ectopic pregnancy, preeclampsia, round ligament syndrome, and preterm labour. [27] Laboratory evaluation may not be helpful and cannot be relied on. Leukocytosis in pregnancy can be as high as 16,000 cells/ml and still considered a normal variant and not a clear indicator of appendicitis.…”

“…This non-invasive procedure should be considered first in working up suspected acute appendicitis. [7,27] Incidence rates in the first trimester range from 19% to 36%, in the second trimester, range from 27% to 60% and in the third trimester, range from 15% to 59%. Due to the lack of specificity of the preoperative evaluation; the pathologic diagnosis of appendicitis is confirmed in only 30% to 50% of cases, considering first trimester yields a greater accuracy.…”

“…Patients in the second and third trimester of pregnancy often have pain in the right upper quadrant or flank, with biliary colic and pyelonephritis representing common misdiagnoses. [7,25,27] The risk of delay in diagnosis is associated with a greater risk of complications such as perforation, infection, preterm labour, and risks of fetal or maternal loss. Maternal mortality has been reported from none to 2%.…”

Appendicitis in Pregnancy: Presentation, Management and Complications

“…Acute appendicitis is the most common surgical Condition which requiring abdominal surgery during pregnancy, its incidence is reported to be between 1:1250 and 1:1500 pregnancies [1,2]. Acute appendicitis has a peak incidence in the second and third decades coinciding with the childbearing years [3].…”

Developing peritonit after perforeted appendicitis, peritoneal abscess peritoneal abse and preterm birth: 2 cases

“…Also it is the most common surgical problem causing fetal death when obstetrical reasons are excluded (4,5) .…”