Maternal and Fetal Outcome in Pregnant Women with Acute Appendicitis: A Three Year Observational Study

Masood, Alaa; Saleh, Said; Shaheen, Abdelhamid; Fakhry, Tamer; Shawky, Mohamed; Badr, Hassan

doi:10.15406/ogij.2016.05.00173

Cited by 4 publications

(4 citation statements)

References 16 publications

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“…However, it would seem from this meta-analysis that the stillbirth rate during acute pancreatitis in pregnancy is much higher than that among the general population of pregnant women (4.4–6.2 and 0.5 per cent respectively) 12 . It would appear that the fetal death rate associated with acute pancreatitis in pregnancy is among the highest of fetal mortality rates for surgical emergencies that may occur during pregnancy; rates for other pathologies include 1.6 per cent for simple appendicitis, 7 per cent for non-operative management of cholecystitis, and 17 per cent for small bowel obstruction 13–15 .…”

Section: Discussionmentioning

confidence: 99%

Acute pancreatitis in pregnancy: meta-analysis of maternal and fetal outcomes

Hughes

White

et al. 2021

British Journal of Surgery

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The impact of acute pancreatitis in pregnancy on maternal and fetal outcomes is unclear. Historical case series document very poor outcomes, with maternal mortality rates of 20 per cent and fetal loss of 50 per cent. However, this is based on outdated clinical practice. This meta-analysis quantified both maternal and fetal outcomes following acute pancreatitis in pregnancy based on the concurrent literature. Maternal and fetal outcomes after acute pancreatitis in pregnancy have improved with advances in the management of pancreatitis.

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Section: Discussionmentioning

confidence: 99%

Acute pancreatitis in pregnancy: meta-analysis of maternal and fetal outcomes

Hughes

White

et al. 2021

British Journal of Surgery

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“…Masood et al . in a prospective cohort study of 118 patients who presented with appendicitis divided the cases into uncomplicated and complicated [ 10 ]. Statistically significant differences were obtained between the rates of operative time, postoperative fever, surgical site infections and poor obstetric outcomes in favour of uncomplicated appendicitis.…”

Section: Discussionmentioning

confidence: 99%

“…Anatomically, as the pregnancy progresses, the position of the appendix is displaced upwards from the right iliac fossa (RIF) by the gravid uterus [ 2 ]. Some of the symptoms of early pregnancy including nausea, anorexia and abdominal discomfort and those of acute appendicitis mimic each other, leading to delays in diagnosis and intervention for acute appendicitis in pregnancy [ 8 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Concurrent ruptured spontaneous heterotopic pregnancy and ruptured appendix with delayed presentation in the first trimester: a case report

Murewanhema¹,

Madombi²,

Hlathswayo³

et al. 2020

Pan Afr Med J

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Acute appendicitis is the commonest non-gynaecological surgical emergency in pregnancy. However, the concurrent occurrence of acute appendicitis with a heterotopic pregnancy is a rare event and presents diagnostic challenges to unsuspecting clinicians and sonographers. We present a case of a woman who had a heterotopic pregnancy and was noted to have a gangrenous appendicitis at laparotomy, illustrating how a diagnosis of acute appendicitis could easily be missed in pregnancy. We report the case of a 34-year-old woman in the first trimester of pregnancy who had a missed diagnosis of acute appendicitis after she had complained of vague abdominal symptoms for three weeks. She presented to a gynaecologist with vaginal bleeding for three days and was noted to have a heterotopic pregnancy on ultrasound scan. At laparotomy, she was noted to have a gangrenous appendicitis with pyoperitoneum concurrent with a ruptured left fimbrial ectopic pregnancy. Left salpingectomy and saline lavage were done and she had uneventful post-operative recovery. Unsuspecting clinicians, in patients without risk factors, can miss both heterotopic pregnancy and acute appendicitis. As assisted reproductive techniques become widespread, the possibility of heterotopic pregnancies must always be considered and any patient who presents with vague abdominal symptoms must be suspected to have the possibility of acute appendicitis. Because of the unreliability of laboratory investigations and clinical predictive scores in pregnancy, sonographers must be specifically asked to scan for heterotopic pregnancy and appendicitis in suspected cases.

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“… 1 Nonetheless, the fetal death rate secondary to APIP is still among the highest fetal mortality rates for surgical emergencies that may occur during pregnancy, compared to other pathologies, including 1.6% for simple appendicitis, 7% for non-operative management of cholecystitis, and 17% for small bowel obstruction. 2 – 4 APIP is more harmful to the fetus than to pregnant women.…”

Section: Introductionmentioning

confidence: 99%

Early predictive value of scoring systems and routine laboratory tests in severity and prognosis of acute pancreatitis in pregnancy

Wang

et al. 2023

Therap Adv Gastroenterol

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Background: Currently, no guidelines specifically recommend scoring systems and biomarkers for early evaluation of the severity and prognosis of acute pancreatitis in pregnancy (APIP). Objectives: This study aimed to explore the early predictive value of scoring systems and routine laboratory tests on APIP severity and maternofetal prognosis. Design: This study retrospectively analyzed 62 APIP cases in a 6-year period. Methods: The predictive value of scoring systems and routine laboratory tests that were collected 24 h and 48 h after admission, for APIP severity and fetal loss, were analyzed. Results: To detect severe acute pancreatitis (SAP), a 24-h Bedside Index for severity in acute pancreatitis (BISAP) achieved a higher area under the curve (AUC) value of 0.910 than the Acute Physiology and Chronic Health Evaluation II (AUC = 0.898) and Ranson score (AUC = 0.880). The combination of BISAP, glucose, neutrophil-to-lymphocyte ratio (NLR), hematocrit (Hct), and serum creatinine (Scr) provided an AUC value of 0.984, which had greater predictive power than BISAP ( p = 0.015). 24-h BISAP and Hct were independent risk factors for predicting SAP of APIP. The cutoff values of Hct and blood urea nitrogen (BUN) to predict SAP were 35.60% and 3.75 mmol/l in the APIP. Furthermore, 24-h BISAP had the highest predictive power (AUC = 0.958) for fetal loss. Conclusion: BISAP is a convenient and reliable indicator for the early prediction of SAP and fetal loss in APIP. The combination of BISAP, glucose, NLR, Hct and Scr proved to be the optimal early markers for the prediction of SAP in APIP within 24 h after admission. In addition, Hct > 35.60% and BUN > 3.75 mmol/l may be suitable thresholds for predicting SAP in APIP.

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Maternal and Fetal Outcome in Pregnant Women with Acute Appendicitis: A Three Year Observational Study

Cited by 4 publications

References 16 publications

Acute pancreatitis in pregnancy: meta-analysis of maternal and fetal outcomes

Acute pancreatitis in pregnancy: meta-analysis of maternal and fetal outcomes

Concurrent ruptured spontaneous heterotopic pregnancy and ruptured appendix with delayed presentation in the first trimester: a case report

Early predictive value of scoring systems and routine laboratory tests in severity and prognosis of acute pancreatitis in pregnancy

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