Appendectomy during pregnancy

Twenty-nine patients suspected of having appendicitis while pregnant had appendectomies, and 20 patients had appendicitis. Right lower quadrant pain and tenderness of less than 24 hours duration with nausea and vomiting, a fever of 38 C or less, and a leukocyte count of more than 15,000 were the more common findings in patients with appendicitis. Right lower quadrant pain and tenderness of more than 24 hours' duration, fever of more than 38 C, and a leukocyte count of less than 15,000 were more common findings in patients with idiopathic right lower quadrant pain or such pain associated with urinary tract infection. Neither fetal nor maternal death or complication occurred. The use of antibiotics and progestational agents appeared to be a matter of choice and did not appear to influence fetal or maternal outcome. These data support the concept that peritonitis rather than appendectomy is the cause of fetal and maternal death and complication in pregnant women suspected of having appendicitis and further argue for early appendectomy in such patients.