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Acute appendicitis in pregnancy: complications and subsequent management
A C Halvorsen1, B Brandt, J J Andreasen
1Department of Obstetrics and Gynaecology, Rigshospitalet, University of Copenhagen, Denmark.
Objective:
To establish guidelines for the management of a pregnancy that is complicated by acute appendicitis.
Design:
Retrospective study.
Setting:
University Hospital, Copenhagen, Denmark.
Subjects:
16 patients operated on for symptoms of acute appendicitis during the 15 year period 1974-1988.
Results:
In 12 patients (75%) the diagnosis was confirmed histologically. The signs and symptoms were classic, and three patients had contractions. One fetus died, in a patient with appendicitis complicated by intraperitoneal abscess. In all uncomplicated cases the pregnancy proceeded to term and the deliveries were normal.
Conclusions:
Pregnancy should not deter a surgeon from removing an appendix, once the diagnosis is suspected; no pregnancy was affected by removal of a normal appendix. We recommend that prophylactic antibiotics and tocolytic drugs be given in all cases. Simultaneous caesarean section should be done only if there are obstetric indications.