Appendicitis in pregnant women: A systematic review and meta-analysis of the diagnostic performance of ultrasonography

J Clin Ultrasound. 2023 Nov-Dec;51(9):1492-1501. doi: 10.1002/jcu.23566. Epub 2023 Sep 25.

Abstract

Objectives: The accuracy of ultrasound in the detection of appendicitis in pregnant women was examined in a meta-analysis.

Methods: Pregnant women with suspected acute appendicitis were evaluated using ultrasound in a systematic search of PubMed, EMBASE, and Cochrane Library databases from January 1, 2011 to August 10, 2023. The sensitivity and specificity values and diagnostic odds ratios were obtained using the pooled data.

Results: A total of 239 patients were studied in four relevant investigations. Ultrasonography has a sensitivity of 56% and a specificity of 88% for the diagnosis of acute appendicitis, with an area under the receiver operating characteristic curve of 0.66%. Ultrasonography had a positive likelihood ratio of 4.65 (95% confidence interval, 1.42-15.23) and a negative likelihood ratio of 0.50 (95% confidence interval, 0.41-0.62). There was no evidence of publication bias (p = 0.93).

Conclusions: Ultrasound has moderate sensitivity for identifying appendicitis in pregnant women and may be utilized as an alternative diagnostic method.

Keywords: appendicitis; meta-analysis; pregnancy; ultrasonography.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Acute Disease
  • Appendicitis* / diagnostic imaging
  • Female
  • Humans
  • Pregnancy
  • Pregnant Women*
  • ROC Curve
  • Sensitivity and Specificity
  • Ultrasonography / methods