Appendectomy during pregnancy in sickle cell disease patients

Acute appendicitis during pregnancy is the most common problem encountered in general surgery. However, limited data are available regarding acute appendicitis in pregnant sickle cell disease (SCD) patients. We aimed to study was the clinical presentation, management, and outcome in SCD patients who underwent appendectomy for suspected acute appendicitis during pregnancy.

Between January 1998 and December 2006, 65 pregnant patients with clinically suspected appendicitis underwent surgery at our hospital of whom 11 were SCD patients. Data collected retrospectively included age, gestational stage, clinical signs and symptoms, operative findings, and complications.

Eleven out of 65 (16.9%) were SCD patients. The mean age in the SCD group was 22.5 years while the mean gravida and parity values were 2.0 and 1.1, respectively. The mean HbS, HbF, and HbA2 values were 71.1, 26.2, and 2.6%, respectively. Abdominal pain and vomiting were the most common presenting symptoms regardless of the gestational age. Abdominal and rebound tenderness were the most common physical signs. The mean operative time was 49 min (range: 35-125 min) and the average length of postoperative hospital stay was 4.7 days (2-8 days). There was no maternal death but one patient had spontaneous abortion during the first trimester, two days after the operation. Two patients had premature, postoperative delivery at 30 and 31 weeks of gestation.

The clinical manifestations and diagnosis of appendicitis in sickler pregnant patients are similar to those in nonsickler pregnant patients.