Acute Appendicitis in Pregnant Patients and Non-Pregnant Patients: Recent Clinical Experience of the Tertiary Hospital

Seo, Seung Won; Kim, Sin Kon

Abstract

PURPOSE: Acute appendicitis is one of the most common surgical problems in pregnancy requiring emergency surgical intervention. To evaluate the clinical characteristics of surgical emergency in pregnancy, we conducted this study.
METHODS
A clinical and pathologic retrospective review was conducted of 42 pregnant and 87 non-pregnant patients who underwent appedectomy with preoperative diagnosis of acute appendicitis at Chonnam National University Hospital from January, to December, 2000.
RESULTS
Thirty-four (81.0%) of the 42 pregnant patients and 75(86.0%) of the 87 non-pregnant patients had pathologically proven acute appendicitis. Among the 34 cases of acute appendicitis in pregnant patients, the gestational stage at presentation was first trimester in 5 (14.7%), second trimester in 23 (67.6%), and third trimester in 6 patients (17.7%). Two instances of combined Caesarian section and 6 of preterm labor or abortion were associated with surgery. Mean leukocyte count was 13,344/mm3 in the pregnant patients and 12,469/mm3 in the non-pregnant patients. Operation time from symptom presentation was 1.90 days in the pregnant patients and 2.70 days in non-pregnant patients. There were some differences between the two groups. Perforation occurred in 4 (11.8%) of the pregnant patients and 13 (17.8%) of the non-pregnant patients. Postoperative wound infection occurred in 9 (26.5%) of the pregnant patients and 11 (14.7%) of the non-pregnant patients.
CONCLUSION
We concluded that there were more difficulties in the diagnosis of acute appendicitis during pregnancy, and that there were no significant differences in clinical findings except for the location of tenderness. Acute appendicitis in pregnancy was associated with fetal morbidity and more rapid progress. In acute abdomen pregnancy, early suspicion and prompt intervention may prevent maternal and fetal complications.