Acute Appendicitis During Pregnancy

Horowitz, Michael D.; Gómez, Gerardo; Santiesteban, Roberto; Burkett, Gene

doi:10.1001/archsurg.1985.01390360028007

Cited by 108 publications

(30 citation statements)

References 12 publications

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“…In the current series, the negative appendectomy rate was 27%. Like other authors, we found the ‘classic’ signs and symptoms to be unreliable [1, 22, 23]. In addition, ultrasonography is unreliable for the diagnosis of appendicitis in pregnancy.…”

Section: Discussionsupporting

confidence: 73%

“…Appendicitis occurs in 1/705 to 1/6,600 pregnancies [1, 20, 22], (1/2,537 in the present series). The clinical diagnosis of appendicitis is substantially more difficult during pregnancy, and negative appendectomy rates as high as 19–50% are reported [1, 10, 23].…”

Section: Discussionmentioning

confidence: 68%

“…Perforation occurs more frequently in pregnant patients, ranging from 14% to as high as 60% in some series [22, 27](current series 31%). This is likely due to greater difficulty in diagnosis and greater delays in surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

“…In this series, there was no maternal mortality. Fetal mortality, however, has historically been higher –1.5–4.8% without perforation and 19–43% with perforation [1, 10, 22, 28]. Even negative appendectomies are associated with 1.2% fetal loss in cases without any pathologic findings [28].…”

Section: Discussionmentioning

confidence: 99%

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Safety and Timing of Nonobstetric Abdominal Surgery in Pregnancy

et al. 2001

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Background/Aims: Abdominal disorders occurring during pregnancy pose special difficulties in diagnosis and management to the obstetrician and surgeon. The advisability of nonobstetric abdominal surgery during pregnancy is uncertain. Our objective was to evaluate the safety and timing of abdominal surgery during pregnancy. Methods: We retrospectively reviewed 77 consecutive gravid patients undergoing nonobstetric abdominal surgery from 1989 to 1996 at an urban academic medical center and a large affiliated community teaching hospital. Medical records were evaluated for clinical presentation, perioperative management, preterm labor, and maternal and fetal morbidity and mortality. Results: The rate of nonobstetric abdominal surgery during pregnancy was 1 in every 527 births. Among the 77 patients, the indications for surgery were adnexal mass (42%), acute appendicitis (21%), gallstone disease (17%) and other (21%). There was no maternal or fetal loss or identifiable neonatal birth defect. Preterm labor occurred in 26% of the second-trimester patients and 82% of the third-trimester patients. Preterm labor was most common in patients with appendicitis and after adnexal surgery. Preterm delivery occurred in 16% of the patients, but appeared to be directly related to the abdominal surgery in only 5%. Conclusion: Surgery during the first or second trimester is not associated with significant preterm labor, fetal loss or risk of teratogenicity. Surgery during the third trimester is associated with preterm labor, but not fetal loss.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Safety and Timing of Nonobstetric Abdominal Surgery in Pregnancy

et al. 2001

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“…Particularly, in late periods of pregnancy with the movement of appendix from its original location, physical findings may be changed. Difficult diagnosis and delay in treatment increase the risk of complications and may result in fetal and maternal morbidity and mortality [2, 3, 4, 5, 6, 7]. In this study, the records of 24 patients who underwent surgery with diagnosis of acute appendicitis in pregnancy were evaluated.…”

Section: Introductionmentioning

confidence: 99%

Acute Appendicitis during Pregnancy

et al. 2002

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Background: To analyze the diagnosis and surgical treatment of acute appendicitis during pregnancy. Methods: The records of 24 pregnant patients who underwent surgery with preliminary diagnosis of acute appendicitis between January 1990 and July 2000 were reviewed retrospectively. Results: Between January 1990 and July 2000, there were 31,480 deliveries and the incidence of acute appendicitis was 1/1,312. Twenty patients had pathologically proven acute appendicitis (83.3%). Of the remaining 4 patients, one had hemorrhagic ovarian cyst, one had ovarian cyst rupture and in two cases no surgical pathology was diagnosed. Gestational stage at the diagnosis was first trimester in 7 patients, second trimester in 12 patients and third trimester in 5 patients. Five patients had abortions and premature delivery occurred in 2 patients. Conclusion: Diagnosis of acute appendicitis is difficult in pregnancy. Delay in diagnosis and surgery results in increase in complications. Emergency surgical intervention should be performed when acute appendicitis is suspected during pregnancy.

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