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 23 February 2018

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News

Suspected acute appendicitis during pregnancy

There is an elevated postoperative abortion rate following appendectomy during the first trimester, find investigators in the May issue of the World Journal of Surgery.

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Acute appendicitis during pregnancy is a rare event.

In this study, investigators from Germany analyzed perioperative data on the treatment of appendicitis between 1974 and 2000.

The team recorded surgical and obstetric data relating to the medical history, the clinical, intraoperative, and histologic findings, and the course of the pregnancy. During the study period 9793 appendectomies were performed. Of these, 94 were in pregnant women. They found that 25% occurred in the first trimester, 51% in the second, and 25% in the third.
During the first trimester the postoperative spontaneous abortion rate was 13%.
World Journal of Surgery

The team found that 50% of the case histories during the second trimester were atypical.

They determined that the overall perforation rate was 15%. The perforation rate for the first, second, and third trimesters was 8%, 13%, and 26%, respectively.

They found that while maternal mortality was 0%, the combined miscarriage/abortion rate was 9%, and infant mortality was 3%.

Furthermore, during the first trimester, the postoperative spontaneous abortion rate was 13% and the additional therapeutic/requested abortion rate 22%.

Dr Torsten Ueberrueck's team concluded, "In view of the elevated postoperative abortion rate and the facility of the clinical diagnosis during the first trimester, the indication for invasive diagnostic measures and surgery requires careful consideration".

"During the second and third trimesters the difficulty of establishing a clinical diagnosis makes it necessary to undertake exploratory surgery early".

World J Surg 2004; 28(5): 508-11
26 May 2004

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