SP2.4 - Appendicetomy in pregnancy: a retrospective analysis of 39 cases between 2012-2022

Abstract

Abstract Background Acute appendicitis is the commonest surgical emergency in pregnant women. Physiological changes during pregnancy can obscure symptoms. Prompt diagnosis and surgical intervention is essential to minimise risks such as sepsis and preterm labour. Objective This study aims to evaluate how gestational age, type of imaging, surgeons' expertise, and antibiotics management affect the surgical outcomes in pregnant patients with acute appendicitis. Methods A retrospective analysis of 39 obstetric cases between 2012 and 2022 in the Royal infirmary of Edinburgh. Statistical methods for analysis including ANOVA were used to compare different surgical techniques, and correlation assessments to investigate links between gestational age and aspects of post-operative care. Results The study found that the surgical method significantly impacted post-operative recovery, with laparoscopic procedures leading to shorter hospital stays and decreased antibiotic use compared to open surgeries (p=0.001169 for hospitalisation length and p=0.01049 for antibiotic course, respectively). Surgeon grade did not significantly alter these outcomes. There was a moderate correlation between gestational age and both post-operative antibiotic duration (r = 0.3293) and length of hospital stay (r = 0.3640. The varied use of imaging techniques across different stages of pregnancy suggests there is no consensus of best practice. Conclusion The study identifies a need for consistent guidelines on treating pregnant women with appendicitis, particularly regarding antibiotic use. The results support the preferential use of minimally invasive surgery and value MRI as a non-invasive diagnostic tool, both contributing to a comprehensive, multidisciplinary approach required for these complex clinical scenarios.