[Appendicitis in pregnancy. Complications and treatment]

In order to establish guidelines for the management of a pregnancy that is complicated by acute appendicitis we carried out a retrospective review of 16 patients that had their appendix removed at the Department of Obstetrics and Gynaecology, Rigshospitalet, University of Copenhagen in the period 1974-1988. The diagnostic accuracy was 12/16 (75%). The signs and symptoms were classic. Uterine contractions may occur. There was one foetal death in a case complicated by an intraperitoneal abscess, and two patients delivered prematurely. Three patients had infectious complications, none of these patients were given prophylactic antibiotics. In all uncomplicated cases the pregnancy proceeded to term and the deliveries were normal. The pregnancy ought not to divert the surgeon's attention from performing prompt appendectomy once the diagnosis is suspected. Prophylactic antibiotics and tocolytic drugs should be used in all cases. Simultaneous caesarean section should be performed only on obstetric indications.