Acute appendicitis complicating pregnancy and the puerperium. A study of 5 cases

This series of 5 cases of appendicitis complicating all stages of pregnancy and the puerperium illustrates particularly the potentially rapid course of the disease and the need to perform laparotomy on suspicion. Diagnosis may be aided, in later pregnancy, by the finding of pain increments when the fetus moves, as well as by the use of Alders test. Though a muscle-splitting incision over the point of maximal tenderness is usually suggested, we recommend a right paramedian incision when the fetus is viable as it gives greater flexibility.