Acute appendicitis during pregnancy: a clinical assessment

Area of Science:

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

Background:

• Acute appendicitis is a leading non-obstetric surgical emergency in pregnancy.
• Appendectomy during pregnancy necessitates careful evaluation of maternal and fetal outcomes.

Purpose of the Study:

• To analyze clinical presentations of acute appendicitis in pregnant patients.
• To assess postoperative outcomes for both mothers and fetuses following appendectomy.
• To identify factors influencing maternal and fetal complications.

Main Methods:

• Retrospective review of 45 pregnant women undergoing appendectomy (July 1991-June 1997).
• Data collected included patient demographics, clinical symptoms, appendiceal pathology, and maternal/fetal complications.
• Long-term outcomes were assessed via telephone follow-up when feasible.

Main Results:

• Appendicitis confirmed in 78% of cases; 86% occurred in the first two trimesters.
• Right lower quadrant pain and tenderness were the most frequent symptoms.
• Delayed surgery (>36 hours) correlated with increased appendiceal inflammation (gangrene/perforation); fetal loss rate was 3% in cases with diseased appendices.

Conclusions:

• Appendectomy during pregnancy is associated with a low rate of fetal loss.
• Delayed surgical intervention increases the risk of severe appendiceal pathology and maternal complications.
• Prompt surgical management is essential for optimal outcomes in pregnant patients with acute appendicitis.