Acute appendicitis in pregnancy: complications and subsequent management.

OBJECTIVE

To establish guidelines for the management of a pregnancy that is complicated by acute appendicitis.

DESIGN

Retrospective study.

SETTING

University Hospital, Copenhagen, Denmark.

SUBJECTS

16 patients operated on for symptoms of acute appendicitis during the 15 year period 1974-1988.

RESULTS

In 12 patients (75%) the diagnosis was confirmed histologically. The signs and symptoms were classic, and three patients had contractions. One fetus died, in a patient with appendicitis complicated by intraperitoneal abscess. In all uncomplicated cases the pregnancy proceeded to term and the deliveries were normal.

CONCLUSIONS

Pregnancy should not deter a surgeon from removing an appendix, once the diagnosis is suspected; no pregnancy was affected by removal of a normal appendix. We recommend that prophylactic antibiotics and tocolytic drugs be given in all cases. Simultaneous caesarean section should be done only if there are obstetric indications.