Laparoscopic Versus Open Appendectomy during Pregnancy: Is Fetal Outcome Really Different?

Abstract

Purpose: To assess maternal and fetal outcome of pregnant women with acute appendicitis underwent open versus laparoscopic appendectomy with emphasis on the pregnancy loss rate. Methods: This was a retrospective review of 116 pregnant women with acute appendicitis between 2011 and 2021 in single center, who were allocated either into open appendectomy (n=68) or laparoscopic appendectomy (n=48). Maternal and fetal outcome was recorded, tabulated and statistically analyzed. Results: There was no significant difference between both groups in terms of the rates of abortion [p>0.05, OR (CI 95%) 1.47 (0.42-5.18)], intrauterine fetal demise [p>0.05, OR (CI 95%) 0.94(0.2-4.39)], preterm delivery [p>0.05, OR (CI 95%) 1.9(0.56-6.45)], placental abruption [p>0.05, OR (CI 95%) 2.23(0.43- 11.53)], mode of delivery (p>0.05) and neonatal admission to NICU (p>0.05). There was no significant difference between both groups regarding perioperative data in terms of duration of symptoms before attending the hospital, final diagnosis, postoperative fever, re-operation, thromboembolism, surgical site infection and histopathology results (p>0.05). Laparoscopic appendectomy was associated with shorter operative time (p<0.05), shorter time for return of bowel motility (p<0.001) and shorter hospital stay (p<0.05). Conclusion: Laparoscopic appendectomy is safe, feasible and minimallyinvasive surgery during pregnancy and not associated with increased pregnancy loss when performed under strict criteria. Larger trials are warranted to confirm or refute these findings.