Acute Appendicitis in Pregnancy

Abstract

Objectives: Acute appendicitis rarely occurs in pregnant women. The purpose of this study is to review our experience of treating acute appendicitis in pregnant women in a 20-year period in order to find the risk of abortion. Patients and Methods: From 1988 to 2007, 2581 pre-menopausal women underwent appendectomy for presumed diagnosis of acute appendicitis. Among them, 28 women (1.08%) were pregnant. The clinical results after appendectomy in these 28 women were retrospectively reviewed. Results: The pathology in these 28 women was acute appendicitis without rupture in 16, ruptured appendicitis in 7, and congestion of the appendix in 5. Overall, 7 patients (25%) experienced postoperative complications, and no maternal mortality occurred. Three patients had abortion and fetal death. All abortions occurred in the second trimester. Among them, two patients had perforated appendicitis complicated with postoperative wound infection and one had appendiceal congestion. One patient had induction of labor with premature delivery with a fetal survival. Conclusions: Acute appendicitis in pregnant women is uncommon. Abortions may occur in any stage of the pathological appendix. Avoiding unnecessary operation appears to reduce the occurrence of complications. The surgeons must make accurate diagnosis and carry out proper operation, and cooperate with anesthesiologists and obstetricians to increase maternal and fetal safety.