DIAGNOSIS, MANAGEMENT AND CLINICOPATHOLOGICAL FEATURES OF ACUTE APPENDICITIS IN PREGNANT WOMEN AND ITS IMPACT ON FETAL OUTCOMES

• Published in: İstanbul Tıp Fakültesi Dergisi Vol. 83; no. 4; pp. 330 - 338
• Main Authors: Şenocak, Rahman, Çelik, Süleyman Utku, Kaymak, Şahin
• Format: Journal Article
• Language: English
• Published: İstanbul Üniversitesi Yayınları 29-10-2020
• Subjects: Tıp; İstanbul; Türkiye; morbidite; Acute appendicitis; gebelik; morbidity; pregnancy; Akut apandisit
• ISSN: 1305-6441; 1305-6441
• DOI: 10.26650/IUITFD.2020.0024

Objective: To evaluate the clinicopathological features and feto-
maternal outcomes of appendicitis during pregnancy.
Material and Method: This study involved comparisons of laboratory
findings, preoperative ultrasonography (US), pathology
and clinical outcomes of 17 pregnant and 59 age-matched
non-pregnant women undergoing appendectomy.
Results: The total number of US scans, rates of non-visualized
appendix on US, and length of hospital stay were higher in pregnant
women than in non-pregnant subjects (p<0.001, p=0.035,
and p=0.014; respectively). The rate of negative appendectomy
was 1.5-times higher and the rate of complicated appendicitis
was 7-times higher in pregnant compared with non-pregnant
patients. The diagnostic accuracy of US was higher in the
non-pregnant group (72.9% vs. 64.7%). In terms of the hematological
parameters, no significant difference was found between
the pregnant patients with and without appendicitis. There was
one premature birth and one abortus in the second trimester,
and one premature birth followed by a negative appendectomy
in the third trimester.
Conclusion: The diagnosis of acute appendicitis in pregnancy
may remain inconclusive despite comprehensive evaluation with
clinical examination, laboratory studies, and US. We recommend
that clinicians consider additional imaging scans when they suspect
appendicitis during pregnancy to avoid unnecessary surgical
interventions. Both complicated appendicitis and negative
appendectomy can cause a non-negligible rate of fetal morbidity
and mortality.