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Recent trend of acute appendicitis during pregnancy

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Abstract

Purpose

We report the clinical presentation, management and outcomes of 33 patients who underwent surgery for acute appendicitis during pregnancy between April 1997 and March 2011.

Methods

Several variables were compared between these 33 patients (pregnant group, n = 33) and non-pregnant females aged 20–40 years who underwent an acute appendectomy during the same period (control group, n = 124).

Results

No significant differences were found between the two groups in terms of the type of anesthesia, operative method, duration of surgery, pathology, duration of antibiotic use, and incidence of surgical site infection, except for a higher frequency of pararectal incision performed and higher leukocyte counts in the pregnant group (P < 0.01). Tocolytic agents were administered to 17 patients (52 %). Preterm labor occurred in 10 patients (30 %), one of whom experienced preterm delivery.

Conclusions

These results suggest that acute appendicitis during pregnancy can be managed successfully without fetal loss.

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References

  1. Sharp HT. The acute abdomen during pregnancy. Clin Obstet Gynecol. 2002;45(2):405–13.

    Article  PubMed  Google Scholar 

  2. Mourad J, Elliott JP, Erickson L, Lisboa L. Appendicitis in pregnancy: new information that contradicts long-held clinical beliefs. Am J Obstet Gynecol. 2000;182(5):1027–9.

    Article  CAS  PubMed  Google Scholar 

  3. Tracey M, Fletcher HS. Appendicitis in pregnancy. Am Surg. 2000;66(6):555–9.

    CAS  PubMed  Google Scholar 

  4. Eryilmaz R, Sahin M, Baş G, Alimoglu O, Kaya B. Acute appendicitis during pregnancy. Dig Surg. 2002;19(1):40–4.

    Article  PubMed  Google Scholar 

  5. Yilmaz HG, Akgun Y, Bac B, Celik Y. Acute appendicitis in pregnancy—risk factors associated with principal outcomes: a case control study. Int J Surg. 2007;5(3):192–7.

    Article  PubMed  Google Scholar 

  6. Gilo NB, Amini D, Landy HJ. Appendicitis and cholecystitis in pregnancy. Clin Obstet Gynecol. 2009;52(4):586–96.

    Article  PubMed  Google Scholar 

  7. Andersson RE, Lambe M. Incidence of appendicitis during pregnancy. Int J Epidemiol. 2001;30(6):1281–5.

    Article  CAS  PubMed  Google Scholar 

  8. Popkin CA, Lopez PP, Cohn SM, Brown M, Lynn M. The incision of choice for pregnant women with appendicitis is through McBurney’s point. Am J Surg. 2002;183(1):20–2.

    Article  PubMed  Google Scholar 

  9. Pastore PA, Loomis DM, Sauret J. Appendicitis in pregnancy. J Am Board Fam Med. 2006;19(6):621–6.

    Article  PubMed  Google Scholar 

  10. Lim HK, Bae SH, Seo GS. Diagnosis of acute appendicitis in pregnant women: value of sonography. AJR. 1992;159(3):539–42.

    Article  CAS  PubMed  Google Scholar 

  11. Williams R, Shaw J. Ultrasound scanning in the diagnosis of acute appendicitis in pregnancy. Emerg Med J. 2007;24(5):359–60.

    Article  PubMed  Google Scholar 

  12. Freeland M, King E, Safcsak K, Durham R. Diagnosis of appendicitis in pregnancy. Am J Surg. 2009;198(6):753–8.

    Article  PubMed  Google Scholar 

  13. Forsted DH, Kalbhen CL. CT of pregnant women for urinary tract calculi, pulmonary thromboembolism, and acute appendicitis. AJR. 2002;178(5):1285.

    Article  PubMed  Google Scholar 

  14. Angel E, Wellnitz CV, Goodsitt MM, Yaghmai N, DeMarco JJ, Cagnon CH, Sayre JW, Cody DD, Stevens DM, Primak AN, McCollough CH, McNitt-Gray MF. Radiation dose to the fetus for pregnant patients undergoing multidetector CT imaging: Monte Carlo simulations estimating fetal dose for a range of gestational age and patient size. Radiology. 2008;249(1):220–7.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Castro AM, Shipp TD, Castro EE, Ouzounian J, Rao P. The use of helical computed tomography in pregnancy for the diagnosis of acute appendicitis. Am J Obstet Gynecol. 2001;184(5):954–7.

    Article  PubMed  Google Scholar 

  16. Pedrosa I, Levine D, Eyvazzadeh AD, Siewert B, Ngo L, Rofsky NM. MR imaging evaluation of acute appendicitis in pregnancy. Radiology. 2006;238(3):891–9.

    Article  PubMed  Google Scholar 

  17. Czeizel AE, Pataki T, Rockenbauer M. Reproductive outcome after exposure to surgery under anesthesia during pregnancy. Arch Gynecol Obstet. 1998;261(4):193–9.

    Article  CAS  PubMed  Google Scholar 

  18. Mazze RI, Källén B. Reproductive outcome after anesthesia and operation during pregnancy: a registry study of 5405 cases. Am J Obstet Gynecol. 1989;161(5):1178–85.

    Article  CAS  PubMed  Google Scholar 

  19. McCubbin JH. Choice of surgical incision for appendectomy during pregnancy. Arch Surg. 1981;116(2):251.

    Article  CAS  PubMed  Google Scholar 

  20. Nezhat FR, Tazuke S, Nezhat CH, Seidman DS, Phillips DR, Nezhat CR. Laparoscopy during pregnancy: a literature review. JSLS. 1997;1(1):17–27.

    PubMed Central  CAS  PubMed  Google Scholar 

  21. Machado NO, Grant CS. Laparoscopic appendicectomy in all trimesters of pregnancy. JSLS. 2009;13(3):384–90.

    PubMed Central  PubMed  Google Scholar 

  22. Sadot E, Telem DA, Arora M, Butala P, Nguyen SQ, Divino CM. Laparoscopy: a safe approach to appendicitis during pregnancy. Surg Endosc. 2010;24(2):383–9.

    Article  PubMed  Google Scholar 

  23. Walsh CA, Tang T, Walsh SR. Laparoscopic versus open appendicectomy in pregnancy: a systematic review. Int J Surg. 2008;6(4):339–44.

    Article  PubMed  Google Scholar 

  24. Wilasrusmee C, Sukrat B, McEvoy M, Attia J, Thakkinstian A. Systematic review and meta-analysis of safety of laparoscopic versus open appendicectomy for suspected appendicitis in pregnancy. Br J Surg. 2012;99(11):1470–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  25. Wilms IM, de Hoog DE, de Visser DC, Janzing HM. Appendectomy versus antibiotic treatment for acute appendicitis. Cochrane Database Syst Rev. 2011;11:CD008359.

    PubMed  Google Scholar 

  26. Varadhan KK, Humes DJ, Neal KR, Lobo DN. Antibiotic therapy versus appendectomy for acute appendicitis: a meta-analysis. World J Surg. 2010;34(2):199–209.

    Article  PubMed  Google Scholar 

  27. Giraudo G, Baracchi F, Pellegrino L. Dal Corso HM, Borghi F. Prompt or delayed appendectomy? Influence of timing of surgery for acute appendicitis. Surg Today. 2013;43(4):392–6.

    Article  PubMed  Google Scholar 

  28. Otake S, Suzuki N, Takahashi A, Toki F, Nishi A, Yamamoto H, Kuroiwa M, Kuwano H. Histological analysis of appendices removed during interval appendectomy after conservative management of pediatric patients with acute appendicitis with an inflammatory mass or abscess. Surg Today. 2014;44(8):1400–5.

    Article  PubMed  Google Scholar 

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Conflict of interest

Drs. Kumamoto, Imaizumi, Hokama, Ishiguro, Ishibashi, Baba, Seki and Ishida have no conflicts of interest or financial ties to disclose.

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Correspondence to Kensuke Kumamoto.

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Kumamoto, K., Imaizumi, H., Hokama, N. et al. Recent trend of acute appendicitis during pregnancy. Surg Today 45, 1521–1526 (2015). https://doi.org/10.1007/s00595-015-1139-x

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  • DOI: https://doi.org/10.1007/s00595-015-1139-x

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