Clinical Outcomes of Acute Appendicitis During Pregnancy: Conservative Management and Appendectomy
- 26 February 2021
- journal article
- research article
- Published by Wiley in World Journal of Surgery
- Vol. 45 (6), 1717-1724
- https://doi.org/10.1007/s00268-021-06010-w
Abstract
Purpose We have described the epidemiology, diagnostic modality, treatment patterns, and outcomes of acute appendicitis during pregnancy. Methods Using a nationwide claim-based database in Japan, we analyzed the data of pregnant patients who were diagnosed with appendicitis between January 2005 and May 2019. Patient characteristics, imaging studies, length of hospital stay, proportion of fetal losses, complications, and type of antibiotics were examined. Results The study included 169 patients, of whom 113 patients (67%) underwent conservative management, and appendectomies were performed on 56 patients (open 25% and laparoscopic 8%). The proportion of ultrasonography, computed tomography, and magnetic resonance imaging were 97%, 17%, and 5% (for conservative management); 88%, 39%, and 13% (for appendectomy); 86%, 38%, and 21% (for open appendectomy); and 93%, 43%, and 14% (for laparoscopic appendectomy), respectively. The proportion of complicated appendicitis was 6% in conservative management and 41% in appendectomy (40% in open appendectomy and 43% in laparoscopic appendectomy), respectively. The incidence of fetal loss was 4% in conservative management, 5% in appendectomy (2% in open appendectomy, and 14% in laparoscopic appendectomy). However, there was only one fetal loss (in laparoscopic appendectomy) in the same case of hospitalization. There were no maternal deaths or serious complications after any treatment. Conclusion All treatments showed acceptable outcomes in appendicitis during pregnancy. Conservative management is considered an acceptable option, especially in uncomplicated cases of appendicitis in pregnant women.Keywords
Funding Information
- Pfizer
This publication has 46 references indexed in Scilit:
- Evaluation of MRI for the Diagnosis of Appendicitis During Pregnancy When Ultrasound is InconclusiveJournal of Surgical Research, 2009
- Appendicitis in pregnancy: an ongoing diagnostic dilemmaColorectal Disease, 2009
- Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)Epidemiology, 2007
- Negative Appendectomy in Pregnant Women Is Associated with a Substantial Risk of Fetal LossJournal of the American College of Surgeons, 2007
- Acute appendicitis in pregnancy — risk factors associated with principal outcomes: A case control studyInternational Journal of Surgery, 2007
- Ultrasound scanning in the diagnosis of acute appendicitis in pregnancyEmergency Medicine Journal, 2007
- Risk factors in miscarriage: a reviewEuropean Journal of Obstetrics & Gynecology and Reproductive Biology, 2002
- Diagnosis of acute appendicitis in pregnant women: value of sonography.American Journal of Roentgenology, 1992
- Acute appendicitis in the pregnant patientThe American Journal of Surgery, 1990
- Acute Appendicitis in PregnancyBMJ, 1960