Evaluation of obstetrical and fetal outcomes in pregnancies complicated by acute appendicitis

The purpose of our study was to evaluate obstetrical and fetal outcomes in pregnancies complicated by acute appendicitis, and to specifically evaluate the impact of peritonitis.

We conducted a population-based cohort study using the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample from 2003 to 2010 to evaluate perinatal outcomes in pregnant patients with appendicitis and delivery in the same admission compared to women delivering without appendicitis. Logistic regression was used to calculate the odds ratio (OR) and corresponding 95 % confidence intervals (CIs) for variables and outcomes of interest.

Among seven million maternities, there were 1,203 women with appendicitis who delivered in the same admission. Pregnant women with appendicitis were more likely to deliver preterm OR 2.68 (95 % CI 2.31-3.11) and had an increased risk in abruptio. Among the 27 % of patients with peritonitis, the rate of preterm birth was fourfold higher, and the caesarean section rate was almost doubled.

Although rare, appendicitis in pregnancy is associated with adverse maternal outcomes and worsened in cases of peritonitis. Measures to decrease risk of peritonitis should be taken in order to limit associated morbidities.