Acute Appendicitis During Pregnancy

ABSTRACT

Diagnosis of acute appendicitis is often difficult in pregnant patients because the symptoms may be attributed to the pregnancy. Difficulty in diagnosis and delay in treatment may result in complication or death to the fetus or the mother. Forty pregnant women with acute appendicitis has been treated at Masan Samsung Hospital during the last 15-years. This report is a retrospective clinical analysis of 40 patients who underwent appendectomy. The results are as follows; The incidence of appendicitis during pregnancy was 1 in 655 pregnancies and the gestational stage at onset included 19 patients(47%) in the 1 trimester, 10 patients(25%) in the second trimester, and 11 patients(27%) in the third trimester. The majority of patients were 3rd decades (82%) and there was no significant difference between primiparity and multiparity in incidence of appendicitis. Twenty three(57%) patients had symptoms less than 12 hours and twenty nine (72%) patients were operated on within 12 hours following hospitalization. Vague right abdominal pain was the most predominant symptom and 19 patients had a clinical leukocytosis. Seven of the 40 patients were misdiagnosed as other than appendicitis and two patients had a exploratory laparotomy performed. Spinal anesthesia was preferably used for the first trimester and general anesthesia for the second and third trimester patients. One fetal loss occurred and no maternal deaths.