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The appendix in pregnancy: confirming historical observations with a contemporary modality
Jason A Pates1, Troy C Avendiano, Michael V Zaretsky
1From the Departments of Obstetrics and Gynecology and Radiology, the University of Texas Southwestern Medical Center, Dallas, Texas.
Objective:
To estimate the position of the appendix in term pregnancy using magnetic resonance imaging (MRI) technique.
Methods:
Appendiceal distance from the iliac crest and axis rotation were determined in women between 39 and 40 weeks of gestation who were undergoing scheduled repeat cesarean delivery. A single-shot fast spin-echo MRI sequence of the maternal pelvis was performed without gadolinium contrast. A board-certified radiologist interpreted the MRIs and measured the distance from the base of appendix (or cecum) to the iliac crest in centimeters as well as the axis of the appendix using clock position annotation.
Results:
Seventy-two women had optimal imaging for interpretation. The mean displacement of the appendix above the iliac crest was 45 mm and was significantly higher than previously described in the term pregnant woman (P<.001).
Conclusion:
Despite recent studies supporting the contrary view, the upward displacement of the appendix in term pregnancy is confirmed in this study.
Level Of Evidence:
II.
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