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Appendicitis in pregnancy.

M Tracey1, H S Fletcher

  • 1Department of Surgery, Saint Barnabas Medical Center, Livingston, New Jersey 07039, USA.

The American Surgeon
|July 11, 2000
PubMed
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Appendicitis in pregnancy occurs in 0.05% of deliveries. While physical exams are key for diagnosis, perforation risk increases with gestational age, but fetal mortality remains zero.

Area of Science:

  • Obstetrics and Gynecology
  • Surgical Diagnosis
  • Maternal-Fetal Medicine

Background:

  • Appendicitis is the most common non-obstetric surgical emergency during pregnancy.
  • Pregnancy-related physiological and anatomical changes can complicate appendicitis diagnosis, potentially increasing maternal and fetal risks.
  • Historical data suggests higher risks of fetal loss and maternal morbidity associated with appendicitis in pregnancy.

Purpose of the Study:

  • To evaluate the incidence of appendicitis in pregnant patients.
  • To identify factors contributing to diagnostic delays in gestational appendicitis.
  • To assess maternal and fetal outcomes for appendicitis during pregnancy.

Main Methods:

  • A retrospective analysis of pregnant patients diagnosed with acute appendicitis between 1991 and 1998.

Related Experiment Videos

  • Data collected included incidence, gestational stage at diagnosis, presenting symptoms, diagnostic methods, and patient outcomes.
  • Comparison of findings with existing literature on appendicitis in pregnancy.

    • Main Results:

    • The incidence of appendicitis in pregnancy was 0.05% (22 cases per 44,845 deliveries).
    • Perforation occurred in 55% of cases, with higher rates in the third trimester; however, no fetal mortality was observed.
    • Physical examination findings like rebound and guarding were the most reliable diagnostic indicators.

    Conclusions:

    • The incidence of appendicitis in pregnancy aligns with previous reports.
    • Physical examination remains a critical diagnostic tool for appendicitis in pregnant individuals.
    • Increased gestational age correlates with a higher risk of appendicitis perforation, yet does not appear to elevate fetal mortality risk.