Acute Appendicitis During Pregnancy: Different from the Nonpregnant State?

Area of Science:

• Obstetrics and Gynecology
• General Surgery
• Emergency Medicine

Background:

• Acute appendicitis is a common surgical emergency during pregnancy.
• Existing literature is limited, primarily consisting of small case series.
• This study addresses the scarcity of data by comparing pregnant and nonpregnant women.

Purpose of the Study:

• To compare the clinical presentation of acute appendicitis in pregnant versus nonpregnant women of reproductive age.
• To evaluate differences in management strategies and surgical outcomes between these two groups.
• To inform perioperative management algorithms for appendicitis in pregnant patients.

Main Methods:

• A retrospective cohort study comparing 92 pregnant patients with 494 nonpregnant patients undergoing appendectomy.
• Data collected included preoperative, operative, and postoperative clinical information.
• Statistical analysis compared patient demographics, diagnostic imaging use, and surgical outcomes.

Main Results:

• No significant differences were observed in patient age, white blood cell count, or operative time between groups.
• Pregnant patients more frequently underwent ultrasound (73% vs 27%) and less frequently CT scans (1% vs 16%).
• Rates of negative appendectomy, complicated appendicitis, and overall postoperative complications were similar in both groups.

Conclusions:

• The clinical presentation and outcomes of acute appendicitis are comparable between pregnant and nonpregnant women.
• Current diagnostic and management approaches for appendicitis appear effective in both populations.
• Similar perioperative management algorithms can be applied to pregnant and nonpregnant women undergoing appendectomy.