Laparoscopic treatment for appendicitis during pregnancy: Retrospective cohort study

Area of Science:

• Surgical outcomes in pregnancy
• Minimally invasive surgery
• Obstetric emergencies

Background:

• Acute appendicitis is the most common non-obstetric surgical emergency in pregnant individuals.
• Laparoscopy offers benefits during pregnancy but carries risks for mother and fetus.
• This study analyzes outcomes of laparoscopic appendicitis treatment in pregnant women.

Purpose of the Study:

• To evaluate the adverse postoperative, obstetric, and fetal outcomes of laparoscopic surgical treatment for acute appendicitis in pregnant women.
• To review existing literature on this topic.

Main Methods:

• Retrospective observational study.
• Inclusion of pregnant women with a preoperative diagnosis of acute appendicitis.

Main Results:

• A total of 63 pregnant women (mean age 28.4 years, gestational age 3-30 weeks) underwent surgery.
• Laparoscopic appendectomy was performed in 92% of cases, with a 3.2% conversion rate.
• Delayed diagnosis (≥48 hours from symptom onset) was associated with a higher rate of perforated appendicitis (31% vs. 11%) and postoperative complications (OR 4.8).
• Complications led to longer hospital stays and an 8-fold increased risk of preterm delivery.
• Obstetric complications were more frequent in the first trimester; fetal mortality was 1.6%.

Conclusions:

• Surgical morbidity in pregnant women with acute appendicitis is primarily linked to delayed diagnosis and treatment.
• Laparoscopic appendectomy during pregnancy is associated with potential postoperative, obstetric, and fetal complications.
• Standardizing complication definitions is crucial for reliable literature comparison.