Appendicitis in pregnancy: management

Mohan S. V. S., Hema Mohan, Sahil Mehta, Swati Prabhu, Akarsh S. Rajput


Background:Acute appendicitis is an infrequent, yet one of the commonest surgical emergency encountered in pregnancy. Recorded incidence is about 1:1500 pregnancies. The aim of this study was to determine the risk factors associated with prenatal outcome in acute appendicitis during second and third trimester pregnancies. Open access surgery was done due to non-availability of laparoscopy.

Methods:A total of 10 pregnant women who were diagnosed with acute appendicitis between Jan 2011 to Jan 2013 were presented and 7 of them operated by open access surgery.

Results: Seven pregnant women who were diagnosed with acute appendicitis were operated upon during late pregnancy. The interval between symptom onset and surgery was the only predictive variable. A longer interval between symptom onset and surgery was associated with appendix perforation than with no appendix perforation. There was a significant difference in the rate of preterm labor (5.1% vs. 1.3%) and the rate of fetal mortality (25% vs. 1.7%) between patients with and without a perforated appendix.

Conclusion:Delaying surgery correlates to more advanced disease with an increased risk of perforation. This contributes to an increased risk of further complications, including premature labor or abortion, and to higher maternal complication rates. Prompt diagnosis may improve the prenatal outcome.



Pregnancy, Appendicitis, Laparotomy

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