Diagnosis, Management and Clinicopathological Features of Acute Appendicitis in Pregnant Women and Its Impact on Fetal Outcomes

Şenocak, Rahman; Çelik, Süleyman Utku; Kaymak, Şahin

doi:10.26650/iuitfd.2020.0024

Cited by 3 publications

(5 citation statements)

References 26 publications

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“…Although laparoscopic surgery was performed in approximately 38% of women diagnosed with acute appendicitis between the study dates, especially in recent years, it was observed that open appendectomy was performed in all pregnant patients. Examining the literature, it was seen that similar results are given in small centers, in accordance with the data in the present study (9,18,19). Laparoscopic surgery is more commonly used in larger centers.…”

Section: Graphic 1bsupporting

confidence: 92%

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Gebeli̇kte Akut Apandi̇si̇t Olgularina Yaklaşim; Bi̇r Devlet Hastanesi̇ Prati̇ği̇

Kırmızı¹

2022

SDÜ Tıp Fakültesi Dergisi

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AmaçAkut apandisit, gebelikte en sık yapılan non-obstetrik cerrahidir. Gebeliğin kendine özgü fizyolojik, anatomik değişiklikleri tanı ve tedavi sürecini güçleştirir. Literatürde bu konuyla ilgili çalışmaların çoğunlukla tersiyer merkezlerin deneyimlerini yansıttığı görülmektedir. Bu çalışmanın amacı gebelikte akut apandisit vakalarına ilişkin ikinci basamak bir hizmet hastanesindeki perioperatif deneyiminin sunulmasıdır. Gereç ve YöntemÇalışma Ocak 2015-Kasım 2020 tarihleri arasında ikinci basamak bir devlet hastanesinde retrospektif olarak yapıldı. Gebelik döneminde akut apandisit tanısı alan, postoperatif takipleri ve doğumları hastanemizde gerçekleştirilen hastalar çalışmaya alındı. BulgularHastaların yaş aralığı 24 yaş (18-35), ortanca gestasyonel hafta 17 hafta (8-32) idi. Ortanca lökosit sayısı 11,6 x10 3 uL, nötrofil sayısı 8,6 x10 3 uL, lenfosit sayısı 2 x10 3 uL, trombosit sayısı 271 x10 3 uL, C-reaktif protein 4,5, nötrofil/lökosit oranı 4,3, trombosit/ lenfosit oranı 120,8, lökosit/ C-reaktif protein oranı 0,7 olarak saptandı. Spinal anestezi en çok tercih edilen yöntemdi ve hastaların tamamında açık cerrahinin uygulanmış olduğu görüldü. Ortanca doğum haftası 38 idi (36-40), sadece bir hastada preterm doğumun geliştiği saptandı. Ek maternal veya fetal komplikasyon gelişmediği görüldü. SonuçMultidisipliner yaklaşım koşuluyla ikinci basamak hizmet hastanelerinde de gebe akut apandisit'li hastalar başarıyla tedavi edilebilir.

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Section: Graphic 1bsupporting

confidence: 92%

“…In the present study, it was seen that spinal anesthesia was preferred in 6.1% of nonpregnant patients, while 77.8% of pregnant patients. These rates were higher than those reported in the literature (9,18,19). This may be due to the defensive approach of anesthesiologists and surgeons.…”

Section: Graphic 1bcontrasting

confidence: 63%

Gebeli̇kte Akut Apandi̇si̇t Olgularina Yaklaşim; Bi̇r Devlet Hastanesi̇ Prati̇ği̇

Kırmızı¹

2022

SDÜ Tıp Fakültesi Dergisi

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“…According to previous studies, the WBC value was significantly higher in patients who underwent AA operation compared with healthy pregnant women and pregnant women with a prediagnosis of AA 4,9 . Moreover, WBC level was found to be higher in pregnant patients with AA diagnosis than in non‐pregnant women with AA diagnosis 16,17 . Previous studies have reported that WBC in AA diagnosis has a sensitivity range of 57.1–72.5%, a specificity range of 52.0–82.9%, and an AUC value of 0.661 4,18 .…”

Section: Discussionmentioning

confidence: 92%

“…4,9 Moreover, WBC level was found to be higher in pregnant patients with AA diagnosis than in non-pregnant women with AA diagnosis. 16,17 Previous studies have reported that WBC in AA diagnosis has a sensitivity range of 57.1-72.5%, a specificity range of 52.0-82.9%, and an AUC value of 0.661. 4,18 WBC value is significantly higher in complicated appendicitis than in uncomplicated appendicitis.…”

Section: Discussionmentioning

confidence: 99%

Significance of laboratory parameters in diagnosing acute appendicitis during pregnancy

Peksöz

Dişçi

Kaya

et al. 2021

ANZ Journal of Surgery

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Background Acute appendicitis (AA) is the most frequently seen surgical emergency in pregnant women and the most frequently encountered cause of non‐obstetric acute abdomen. Due to the physiological and anatomical changes that occur during pregnancy and the limited use of radiological methods, it is difficult to diagnose AA during pregnancy. These conditions increase the risk of morbidity and mortality; therefore, it is crucial to identify ideal laboratory markers that can be utilized to diagnose disease. Methods One hundred and ten pregnancies that fulfilled the inclusion criteria for AA diagnosis were retrospectively analysed between 2010 and 2021. Markers with high diagnostic values were discussed. Results The patients were divided into three groups as follows; Group I: negative appendectomy (n = 19); Group IIa: uncomplicated appendicitis (n = 59); Group IIb: complicated appendicitis (n = 32). There was no statistically significant difference in mean age or gestational week (P > 0.05). Group IIb had a higher rate of complications and a longer length of hospital stay (P < 0.05). There were significant differences between the groups in terms of white blood cell (WBC), neutrophil, neutrophil‐to‐lymphocyte ratio (NLR), platelet‐to‐lymphocyte ratio (PLR), C‐reactive protein, lymphocyte‐to‐ C‐reactive protein ratio, total, direct, and indirect bilirubin values (P < 0.05). While platelet and lactate dehydrogenase (LDH) values did not differ substantially between groups, both were found to have a high diagnostic value. Conclusion It was concluded that WBC, neutrophil, NLR, PLR, total, direct and indirect bilirubin levels could be utilized to diagnose AA. Moreover, levels of WBC, neutrophil, NLR, platelet, PLR, LDH, total, direct and indirect bilirubin can be utilized to diagnose complicated appendicitis.

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“…Research on the best surgical technique for treating acute appendicitis among pregnant women has shown inconsistent findings. (ŞENOCAK et al, 2020). This study intends to give knowledge about the best surgical technique for treating acute appendicitis among pregnant women.…”

Section: Introductionmentioning

confidence: 99%

Incidence of Conversion to Open Appendectomy From Laparoscopic Appendectomy in Pregnant Females

HASSAN,

MAHAR,

ZAHRA

2024

Biol Clin Sci Res J

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Acute appendicitis is a common non-obstetric indication for surgery in pregnant women, and the choice between laparoscopic and open appendectomy remains a subject of debate. While the benefits of laparoscopic appendectomy over open surgery are well-established in the non-pregnant population, consensus is lacking in the pregnant cohort. This study aims to contribute insights into the optimal surgical approach for acute appendicitis in pregnant women. The study, conducted from January 2020 to December 2022 at Nishtar Hospital, Multan, focused on 45 pregnant women presenting with abdominal pain and diagnosed with acute appendicitis. Two patients were discharged after magnetic resonance imaging (MRI) revealed a normal appendix. Of the remaining 43 cases, 27 were in the first trimester, 8 in the second trimester, and 8 in the third trimester. All patients underwent successful laparoscopic appendectomy without any conversion to open surgery. The laparoscopic procedure duration ranged from 50 to 80 minutes, with an average postoperative hospital stay of 1.5-3 days. Postoperative wound infection occurred in three patients (6.66%), and two patients (4.44%) experienced preterm labor. Fetal outcomes, assessed through Apgar grading, size, and weight, showed no notable abnormalities after birth. Laparoscopic appendectomy, regardless of gestational age, proves generally safe and suitable for pregnant women with acute appendicitis. The procedure has minimal complications, making it a viable and preferred option during pregnancy. These findings advocate for the continued consideration of laparoscopic appendectomy as a standard approach for managing acute appendicitis in pregnant patients.

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Diagnosis, Management and Clinicopathological Features of Acute Appendicitis in Pregnant Women and Its Impact on Fetal Outcomes

Cited by 3 publications

References 26 publications

Gebeli̇kte Akut Apandi̇si̇t Olgularina Yaklaşim; Bi̇r Devlet Hastanesi̇ Prati̇ği̇

Gebeli̇kte Akut Apandi̇si̇t Olgularina Yaklaşim; Bi̇r Devlet Hastanesi̇ Prati̇ği̇

Significance of laboratory parameters in diagnosing acute appendicitis during pregnancy

Incidence of Conversion to Open Appendectomy From Laparoscopic Appendectomy in Pregnant Females

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