Acute appendicitis during pregnancy: case series of 20 pregnant women

BACKGROUND: Acute appendicitis (AA) is the most common cause of acute abdomen during pregnancy. Most of the signs of appendicitis are also found during normal pregnancy period, however, and diagnosis of appendicitis during pregnancy remains challenging. The aim of the current study was to report our clinical experience of AA during pregnancy and investigate optimal management of this difficult situation.
METHODS: Records of 20 pregnant women with diagnosis of AA who underwent appendectomy between 2005 and 2015 were included in this study. Data were collected retrospectively. Patients were evaluated according to age, signs and symptoms, gestational age, physical findings, serum white blood cell count, ultrasound (US) findings, pathology reports, surgical technique, operation time, and complications.
RESULTS: Of 20 patients, 16 (80%) underwent open appendectomy and 4 (20%) underwent laparoscopic appendectomy. Mean age of patients was 29.6±5.6 years. Most common symptom was abdominal pain (95%). Six (30%) patients were in first trimester, 9 (45%) patients were in second trimester and 5 (25%) patients in were in third trimester. US findings consistent with AA were found in 12 (60%) patients. Negative appendectomy rate was 30%. Maternal complication was seen in only 1 (5%) patient. No fetal complication was observed.
CONCLUSION: Accurate diagnosis and prompt surgical treatment of AA in pregnant women should be performed due to high rates of maternal and fetal complications.

Gebelikte akut apandisit: 20 hamile kadýn olgu çalýþmasý

AMAÇ: Hamilelikteki en sýk akut karýn nedeni akut apandisittir. Apandisit bulgularýnýn çoðu normal hamlilelik sürecinde olabileceðinden, gebelerde akut apandisit tanýsý zordur. Çalýþmamýzýn amacý, hamilelik döneminde karþýlaþtýðýmýz akut apandisit olgularýný aktarmak ve bu zor durumda uygun tedaviyi araþtýrmak.
GEREÇ VE YÖNTEM: 2005–2015 yýllarý arasýnda akut apandisit nedeniyle ameliyat edilen 20 hamile kadýn hasta çalýþmaya dahil edildi. Veriler geriye dönük olarak toplandý. Hastalar, yaþ, bulgu ve semptomlar, gestasyon yaþý, fiziksel inceleme bulgularý, ameliyat süresi ve komplikasyon açýsýndan incelendi.
BULGULAR: On altý (%80) hastaya açýk, dört (%20) hastaya laparoskopik apendektomi yapýldý. Ortalama yaþ 29.6±5.6 yýldý. En sýk semptom karýn aðrýsýydý (%95). Altý (%30) hasta 1. üç ayda, dokuz (%45) hasta 2. üç ayda ve beþ (%25) hasta son üç ayda idi. On iki (%60) hastada ultrasonografide akut apandisit bulgusu saptandý. Negatif apendektomi oraný %30’du. Sadece bir (%5) hastada maternal komplikasyon saptandý. Hiç fetal komplikasyon saptanmadý.
TARTIÞMA: Yüksek maternal ve fetal komplikasyon oranlarýndan dolayý, gebelerde akut apandisitin doðru tanýsý ve hýzlý cerrahi tedavisi yapýlmalýdýr.