Ceresoli Marco, Rigamonti Vera, Famà Ilenia, Braga Marco, Corrao Giovanni, Locatelli Anna, Cantarutti Anna
School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
General and Emergency Surgery Department, Fondazione IRCCS San Gerardo dei Tintori di Monza, Monza, Italy.
Arch Gynecol Obstet. 2025 Jan;311(1):33-42. doi: 10.1007/s00404-024-07894-4. Epub 2024 Dec 20.
Acute appendicitis during pregnancy poses unique challenges due to altered anatomical and physiological dynamics and concern about foetal well-being. This study aimed to assess management strategies and outcomes of acute appendicitis during pregnancy, focusing on non-operative management versus surgical intervention.
The study is based on the computerized healthcare utilization database of Lombardy.
In Lombardy, a total of 1,231,040 deliveries were identified. Acute appendicitis during pregnancy occurred in 0.03% of cases, with 74.49% of these cases classified as uncomplicated. Appendicitis during pregnancy was associated with worse maternal and perinatal outcomes. Among uncomplicated cases, 38.46% were treated with non-operative management. Perinatal outcomes did not significantly differ between non-operative management and surgery groups. Additionally, a declining trend in surgical treatment over the study period was observed (P = 0.0477), possibly indicating a shift towards conservative management.
The findings suggest that non-operative management may be a viable option for selected pregnant patients with uncomplicated appendicitis, potentially avoiding surgical complications and allowing for faster recovery. Further research is warranted to validate these findings, explore evolving trends, and refine clinical guidelines for managing acute appendicitis during pregnancy.
由于解剖和生理动态变化以及对胎儿健康的担忧，妊娠期急性阑尾炎带来了独特的挑战。本研究旨在评估妊娠期急性阑尾炎的管理策略和结局，重点关注非手术治疗与手术干预。
该研究基于伦巴第的计算机化医疗利用数据库。
在伦巴第，共识别出1,231,040例分娩。妊娠期急性阑尾炎发生率为0.03%，其中74.49%的病例为非复杂性阑尾炎。妊娠期阑尾炎与孕产妇和围产期结局较差相关。在非复杂性病例中，38.46%接受了非手术治疗。非手术治疗组和手术组的围产期结局无显著差异。此外，在研究期间观察到手术治疗呈下降趋势（P = 0.0477），这可能表明治疗方式正转向保守治疗。
研究结果表明，对于部分患有非复杂性阑尾炎的孕妇，非手术治疗可能是一种可行的选择，有可能避免手术并发症并实现更快恢复。有必要进行进一步研究以验证这些发现，探索不断变化的趋势，并完善妊娠期急性阑尾炎的临床管理指南。
