Can Patients with Appendicitis in Pregnancy be Operated in Secondary Hospital: A retrospective Study

Abstract

Appendicitis is the most common non-obstetric cause of acute abdomen in pregnancy. Diagnosis of appendicitis becomes difficult with the change of appendiceal position during pregnancy. Late diagnosis and treatment increase the likelihood of developing perforation. In this study, we aimed to evaluate perioperative outcomes of appendicitis in pregnant patients in secondary hospitals in the light of the literature. 29 pregnant women who performed appendectomy between April 2012 and July 2017 were included in the study. Patients were evaluated according to age, gestational age, white blood cell count, percentage of neutrophil count, C-reactive protein level, ultrasonographic findings, pathologic results, duration of hospitalization and complications. Out of the 29 pregnant patients, 9 (31.0%) patients had surgery during the first trimester, 13 (44.8%) during the second trimester and 7 (24.2%) during the third trimester. Median white blood cell count was 12870 K/mm3 (min-max;7170-25210). Negative laparotomy rate was %31.0. Median duration of hospitalization was 3.24 days (2-7). Morbidity was observed in 2 (6.9%) of 29 patients. Intra-abdominal abscess was observed in one patient and colonic fistula was observed in one patient. Our results demonstrated that appendectomy and follow-up of pregnant patients with acute appendicitis can be performed at secondary hospitals.