The diagnosis of appendicitis during pregnancy and maternal and fetal outcome after appendectomy.

OBJECTIVE: A review of the literature reveals contradictive conclusions regarding appendicitis during pregnancy due to the few patients included in previous reports.

METHODS: From 1980 to 1985, the Danish National Patient Registry identified the patients having the WHO codes Y60 (pregnancy), 54000 (acute appendicitis) and the operation code 43 000 (appendectomy). Each patient's file was reviewed by the authors.

RESULTS: The ratio of appendicitis (n = 58) to appendectomy (n = 117) was 50%. The appendicitis group was significantly older (26.2 years) than the normal appendix group (23.8 years). Second trimester had the highest incidence of appendicitis, perforated appendicitis and normal appendix. No effect of tocolytic agents could be demonstrated. No maternal mortality. Obstetrical complications were few and appeared only in the group having a normal appendix and first after discharge.

CONCLUSIONS: Pregnant women suspected of having appendicitis should be evaluated as non-pregnant women. Use of tocolytic agents is a matter of choice. Obstetrical complications are few and not related to the surgical trauma.