A case series of 46 appendectomies during pregnancy

Among appendicitis patients pregnant ones occupy only a small proportion. Still there are difficulties in the diagnosis and management of the acute appendicitis in pregnant population. We tried to find answers to these difficulties with our acute appendicitis cases in pregnant patients.

This study involved 46 pregnant patients who received an operation following diagnosis of acute appendicitis in our clinic from 2006 to 2009. Data were collected retrospectively from medical records. Age, time delay to diagnosis, leukocyte count (WBC), gestational age, gestational history, morbidity-mortality and pathology results were evaluated.

The mean age of patients, gestational age and number of prior pregnancies were 26, 21 and 2.6, respectively. The amount of time spent in the hospital, from presentation of first symptom to admission, was approximately 40 hours (range 6-120). The mean time from admission to operation was 5.89 (range 1-32) hours. The perforation rate among our cases was 21%. The negative appendectomy rate was 13%. The perforation rate was associated with advanced gestational age and delayed admission to the hospital (p ≤ 0.001 and p = 0.027, respectively).

The diagnosis of appendicitis in pregnancy is difficult, and the perforation rate is high. Particularly in term pregnancies, we recommend performing appendectomy immediately after cesarean section.