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Acute appendicitis in pregnancy.

T M McGee1

  • 1Westmead Hospital, Sydney, New South Wales.

The Australian & New Zealand Journal of Obstetrics & Gynaecology
|November 1, 1989
PubMed
Summary
This summary is machine-generated.

Diagnosing acute appendicitis in pregnancy is challenging, as symptoms and tests are unreliable. Early surgical intervention is crucial to prevent severe outcomes, as perforated appendicitis significantly increases perinatal mortality.

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Area of Science:

  • Obstetrics and Gynecology
  • Surgical Gastroenterology

Background:

  • Acute appendicitis is the most frequent non-gynecological surgical emergency during pregnancy.
  • Accurate diagnosis is often complicated by overlapping symptoms with other pregnancy-related conditions.

Purpose of the Study:

  • To provide guidelines for the diagnosis and management of acute appendicitis in pregnant patients.
  • To emphasize the importance of timely surgical intervention based on clinical experience and literature review.

Main Methods:

  • A comprehensive review of a decade of clinical experience at a major teaching hospital.
  • Extensive literature review on appendicitis in pregnancy, focusing on diagnostic challenges and management outcomes.

Main Results:

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  • Standard diagnostic methods (symptoms, physical examination, investigations) show limited utility in pregnant patients.
  • Perforated appendicitis is associated with a substantial increase in perinatal mortality, rising from <3% to 20%.

    • Conclusions:

    • The principle of 'if in doubt, take it out' is critically important in managing suspected acute appendicitis during pregnancy.
    • Prompt surgical exploration is recommended due to the high risks associated with delayed diagnosis and perforation.