Acute appendicitis in pregnancy: 50 case series, maternal and neonatal outcomes

Abstract

BACKGROUND: During pregnancy, the most common indication for non-obstetric surgery in acute abdomen is appendicitis. In pregnancy, appendicitis may be confused with pregnancy-related pathologies and may cause a delay in diagnosis or unnecessary surgery. The present study aims to evaluate the maternal and neonatal outcomes of patients undergoing appendectomy during pregnancy. METHODS: This study was designed retrospectively between 2011–2017. Appendicitis detection rates, admission and laboratory features, operation results and obstetric results were evaluated in pregnant women who underwent surgery for a preliminary diagnosis of acute appendicitis. RESULTS: The findings showed that 2593 patients underwent an appendectomy, 1154 of them were women and 50 of them were pregnant. Negative laparotomy was detected in 12 (16%) patients. Six (12%) of these 50 patients had a laparoscopic appendectomy and 44 (88%) had an appendectomy with laparotomy. The mean time to operation after admission to hospital was 10.5±11 hours. No maternal mortality was observed. Preterm labor occurred in four (8%) patients. Two patients (4%) were in the second trimester and two patients (4%) were in the third trimester. Two (4%) newborns born in the second trimester died postpartum. One of these newborns had multiple anomalies. Appendectomy was not characterized by an increased risk of perinatal mortality. CONCLUSION: Delay in the diagnosis and surgery of acute appendicitis during pregnancy may increase the risk of perinatal mortality and should not be delayed in diagnosis and surgery in pregnancy.