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[Appendicitis in pregnancy]

U Retzke1, H Graf, M Schmidt

  • 1Klinik für Frauenheilkunde und Geburtsmedizin, Klinikum Suhl/Thüringen.

Zentralblatt Fur Chirurgie
|January 9, 1999
PubMed
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Appendicitis in pregnancy occurs as frequently as in the general population, with ultrasound aiding diagnosis. Prompt treatment is crucial to minimize risks to both mother and baby.

Area of Science:

  • Obstetrics and Gynecology
  • Surgical Gastroenterology

Background:

  • Appendicitis incidence in pregnancy mirrors the general population, approximately 1:1000-1:1500 pregnancies.
  • Classic appendicitis symptoms are less reliable during pregnancy, complicating diagnosis.
  • Pregnancy-related appendicitis poses significant risks, including spontaneous abortion, preterm delivery, and neonatal mortality.

Purpose of the Study:

  • To review the diagnosis and management of appendicitis during pregnancy.
  • To highlight the impact of appendicitis and its treatment on pregnancy outcomes.
  • To provide guidance on surgical approaches based on gestational age.

Main Methods:

  • Review of existing literature on appendicitis in pregnancy.
  • Emphasis on diagnostic tools like graded compression ultrasound.

Related Experiment Videos

  • Discussion of surgical interventions, including laparoscopy and laparotomy, and their timing.

    • Main Results:

    • Appendicitis increases risks of spontaneous abortion, preterm birth, low birth weight, and early neonatal death.
    • Post-appendectomy, preterm delivery rates rise for seven days, with pregnancies typically continuing to term thereafter.
    • No increase in fetal malformations was observed following appendectomy.
    • Late-pregnancy appendicitis often presents with severe forms (phlegmonous, perforated) and peritonitis.

    Conclusions:

    • Graded compression ultrasound is vital for diagnosing suspected appendicitis in pregnant individuals.
    • Laparoscopy is recommended before 20 weeks of gestation; laparotomy is preferred after 20 weeks.
    • Cesarean section is solely for obstetric indications, not appendectomy treatment; tocolysis should be avoided due to pulmonary risks.