Apendicectomía en la embarazada. Experiencia en un hospital público chileno

Abstract

Background: Acute appendicitis is the most common non obstetric surgical emergency during pregnancy. Aim: To asses our experience in the diagnosis and management of acute appendicitis occurring during pregnancy. Patients and methods: Data from all pregtiant patients who were subjected to an appendectomy for a suspected acute appendicitis from January 1998 to December 2002, were retrospectively analyzed. All pathological, surgical, clinical records and the delivery outcome registry of each patient were reviewed. Results: Among 47,322 deliveries, 46 pregnant women aged 29±9 years and with a gestational age of 21±7 weeks, were operated because of a presumptive acute appendicitis. Forty (87%) had a histopa thologically proven appendicitis; ten (25%) cases had a perforated appendix and 30 (75%) had a non-perforated appendicitis. Five (10.9%) patients had a negative kparotomyand one had a necrotic ovarian tumor. Patients with perforated and non perforated appendices had a similar lapse from the onset of symptoms to operation (69±45 and 50±34 hours respectively, NS) and a similar white cell count (15,667±3,707 and 13,006±5,206 cells/mm3, respectively, NS). Wound infection was the mast common surgical complication in 15%. Seven (15%) patients had a premature delivery and there was one fetal death (2.2%). There were no pregtiancy complications on negative appendectomy cases. Conclusions: Acute appendicitis continues to be a challenge in diagnosis and treatment during pregnancy. Maternal and fetal outcome was better than previously reported.