PARAMETERS ASSOCIATED WITH ACUTE APPENDICITIS IN PREGNANCY

Abstract

Objective
 Acute appendicitis is the most common cause of nonobstetric
 acute abdomen in pregnant women. The
 fact that sympathomatology brings to mind primarily
 obstetric causes in pregnant patients, physiological
 leukocytosis is observed throughout pregnancy, and
 limitations in imaging methods cause confusion in the
 diagnosis. This makes the need for detailed evaluation
 in laboratory parameters inevitable. The aim of
 the study is to reveal the relationship of laboratory
 parameters such as neutrophil lymphocyte ratio
 (NLR), platelet lymphocyte ratio (PLR), lymphopenia
 with the diagnosis of appendicitis and its diagnostic
 power.
 Material and Method
 In the evaluation of 31 patients who were operated
 on with the diagnosis of acute appendicitis during
 pregnancy between January 2017 and February
 2021 were evaluated. Correlation and roc analysis
 were performed by evaluating patients' demographic
 data, laboratory results, ultrasonography or magnetic
 resonance imaging reports and intraoperative
 findings.
 Results
 A significant correlation was found between
 detection of appendicitis in exploration and increased
 neutrophils, leukocytosis, and NLR (p: 0.014, p:
 0.015, p: 0.020, respectively). Again, the presence
 of lymphopenia, high NLR and increased palletelet /
 lymphocyte ratio (PLR) were found to be associated
 with prolonged hospitalization (p:0.037, p:0.008, and
 p:0.024, respectively). Roc analysis also showed that
 leukocytosis [AUC: 0.938 (95%CI: 0-1.00, p:0.019)],
 neutrophil elevation [AUC: 0.938 (95%CI: 0-1.00,
 p:0.019)] and NLR [AUC: 0.917 (0-1.00 p: 0.025)]
 was found to have the power to reveal the presence
 of significant acute appendicitis.
 Conclusion
 It is recommended to use hemogram parameters and
 imaging methods effectively in the diagnosis of acute
 appendicitis in pregnants.