Appendicitis in Pregnancy

Excerpt

Acute appendicitis is a clinical diagnosis confirmed by histopathological findings characterized by inflammation of the vermiform appendix. Clinically, acute appendicitis usually presents acutely within 24 hours. However, the presenting symptoms can be more indolent if appendiceal perforation results in the formation of a contained abscess. The clinical course of acute appendicitis can be highly variable, and the diagnosis may be challenging, particularly in pregnant patients.

Acute appendicitis is the leading cause of nonobstetric surgical disease in pregnant patients. Diagnosing and treating appendicitis promptly during pregnancy is essential to avoid potentially life-threatening complications for both the gravida and the fetus. However, diagnosing acute appendicitis during pregnancy can be challenging since the stereotypical signs and symptoms may not be apparent or easily confused with the typical symptoms of pregnancy. Furthermore, the gravid uterus can displace the appendix and complicate the clinical picture. Standard biochemical and laboratory indicators commonly used in the diagnosis of acute appendicitis may be less reliable during pregnancy.

The general pathogenic, diagnostic, and therapeutic principles of acute appendicitis during pregnancy follow the same pattern as in nonpregnant patients, with specific modifications to accommodate the physiology of normal pregnancy and the growing fetus.