Acute appendicitis in pregnancy : a study of 120 cases of acute abdomen in pregnant patients

Abstract EN

Objective.: The study reviews pregnant patients with acute abdominal pain who were admitted to the surgical ward of Obaisie Hospital in Damascus, Syria, between 1996-2001 in order to determine the incidence, describe \the clinical indications and outcomes, and delineate areas for improvement in early diagnosis in order to reduce maternal morbidity and fetal mortality.

/ketheis: The charts of 120 pregnant women with acute abdomen were reviewed for personal data including age, mrity, symptoms, clinical features, investigations and the time interval between the onset of pain and surgery.

\Operative reports were also reviewed, as were pathological reports.

Appendicitis was confirmed mstopathologically.

TZesulls: Of the admissions, 96 (80%) were suspected of suffering from acute appendicitis.

Of these 20 (21%) were in the first trimester, 56 (58%) were in the second trimester, 18 (19%) were in the third trimester, and 2 (2%) iiere in the puerperium.

Right-sided abdominal pain was the most important symptom for diagnosis.

Laboratory mvestigations were helpful in reaching a decision for operation.

Appendicectomy was performed by gridiron uncision in 79 (82%) of cases.

The others were performed via a midline incision.

Perforation was found in 6 (6%) cases.

In all of these cases, the symptoms exceeded 2 days.

Wound infection occurred in 8 (8%) of cases, 3 of which had perforated appendix.

Other conditions in the admitted patients (24 of the 120 patients) included ectopic gestation (8), acute cholecystitis (6), and right-sided ureteric colic (6).

Conclusion: The atypical presentation of appendicitis may result in hesitancy in both the surgeon and obstetrician to subject a pregnant woman to anesthesia and surgery, which in turn leads to delayed diagnosis.

Early diagnosis and surgical intervention is vital to minimize the occurrence of perforation and possible complications to the fetus