Clinical Analysis of 36 Appendectomies in Pregnant Women

Lee, Chong Suk; Joo, Dae Hyun; Lee, Han Il; Park, Sung Hwan; Yoo, Yong Oon; Kim, Yang Il; Park, Ki Ho

Abstract

Appendicitis is the most common acute abdominal condition that requires an operation during pregnancy. Variable clinical presentations in pregnant women make the diagnosis of acute appendicitis difficult, delay operative intervention, and cause many fetal or maternal complications. From January 1990 through December 1996, 36 appendectomies were performed on pregnant women at our hospital. This is a retrospective analysis of our cases compared to control group. 1. Thirty six pregnant women (0.1 %) from all labor cases during this period underwent appendectomies, representing 10.3 % of all appendectomies in women of childbearing age. 2. The age distribution was 21-25 (38.9 %), 26-30 (55.6 %) and 31-35 (5.5 %) years, which was similar to the age distribution of the non-pregnant group. 3. Acute appendicitis during pregnancy was most common in the spring. 4. No significant difference in the occurrences of various symptoms between the pregnant and the non-pregnant groups was observed. 5. The pregnant patients visited our hospital earlier, but underwent operations later, than the non-pregnant women. (p < 0.05) 6. An increase in the WBC count to above 15,000/mm3 was more common in the pregnant patients with appendicitis.(p < 0.05) 7. The appendix was normal in 22.2 % of the appendectomy cases during pregnancy; however, no significant difference in diagnostic accuracy was observed between pregnant and non-pregnant groups. (p > 0.05) 8. No significant differences between the pregnant and the non-pregnant groups were noticed in terms of operation time and types of anesthesia. (p > 0.05) 9. The wound infection rates were similar for the pregnant (16.7 %) and the non-pregnant (17.4 %)groups, but there were 3 fetal losses (8.3 %)from pregnant patients after their appendectomies. 10. The mean hospital stay was longer for the pregnant patients (7.6 days) than for the non-pregnant group (6.2 days).