Diagnosis of appendicitis during pregnancy and perinatal outcome in the late pregnancy

• Published in: Chinese medical journal 2009-03, Vol.122 (5), p.521-524
• Main Authors: Zhang, Yan, Zhao, Yang-yu, Qiao, Jie, Ye, Rong-hua
• Format: Article
• Language: English
• Subjects: Adult; Appendicitis - complications; Appendicitis - diagnosis; Appendicitis - surgery; Female; Gestational Age; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications - etiology; Pregnancy Outcome; Retrospective Studies; Windows; Young Adult; 北京大学第三医院; 围产期结果; 妊娠晚期; 延迟诊断; 急性阑尾炎; 阑尾穿孔
• ISSN: 0366-6999; 2542-5641
• DOI: 10.3760/cma.j.issn.0366-6999.2009.05.007

Background Appendicitis is the most common surgical problem in pregnancy, however the particular dangers of appendicitis in pregnancy lie in the varied presentation of symptoms and the higher chance of delayed diagnosis. The aim of this study was to determine the risk factors associated with prenatal outcome in acute appendicitis during second and third trimester pregnancies. Methods This was a retrospective single-center study that presented a descriptive analysis of the results. A total of 102 pregnant women who were diagnosed with acute appendicitis and operated upon in Peking University Third Hospital, China between January 1993 and December 2007 were presented. SPSS 12.0 for Windows was used for data analysis. Results Seventy-eight pregnant women who were diagnosed with acute appendicitis （sixteen patients had a perforated appendix, 62 patients had a non-perforated appendix） were operated upon during late pregnancy. The interval between symptom onset and surgery was the only predictive variable. A longer interval between symptom onset and surgery was associated with appendix perforation （（109.5±52.7） hours） than with no appendix perforation （（35.1±19.62） hours; P=-0.007）. There was a significant difference in the rate of preterm labor （5.1% vs 1.3%） and the rate of fetal mortality （25% vs 1.7%） between patients with and without a perforated appendix. Conclusions Delaying surgery correlates to more advanced disease with an increased risk of perforation. This contributes to an increased risk of further complications, including premature labor or abortion, and to higher maternal complication rates. Prompt diagnosis may improve the prenatal outcome.