Appendicitis in Pregnancy

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What is appendicitis in pregnancy? - This refers to the inflammation (infection, swelling with associated pain) of the appendix in a pregnant woman. When it occurs in pregnancy, one of the challenges is delay in diagnosis.

This is because of the physical changes associated with pregnancy and how these affect the symptoms, resulting in higher risks of complications such as perforation, which may adversely affect both the fetus and the mother. 

How common is appendicitis in pregnancy?

Appendicitis is not common in pregnancy; occurring in about 1 in 1,500 pregnancies. However, when it occurs, it is more common in the first six months than the last three months of pregnancy.

What makes appendicitis in pregnancy different?

The pain of appendicitis in pregnancy may not present on the right lower part of the abdomen as it is in the general population.This is because the appendix may have been displaced from its location on the right lower abdomen by the growing uterus, especially in the second and third trimesters.

The pain may therefore occur higher in the abdomen. Other symptoms such as nausea, vomiting and loss of appetite are symptoms also commonly associated with pregnancy. This may cause delay in diagnosis; therefore predisposing the woman to rupture, which may adversely affect both the fetus and the mother.

How is appendicitis treated in pregnancy?

The treatment of appendicitis in pregnancy, as it is in the general population, is surgery (appendectomy). This may be through laparoscopy in the first and early second trimesters. Open surgery may be necessary later in the second trimester and in the third trimester.

What are the complications of appendectomy during pregnancy?

Pregnant women who have appendectomy may have the following:

  1. Preterm contractions - Medication may be given after the procedure to lower the chances of this progressing into labour.
  2. Preterm delivery - The higher the age of the pregnancy at diagnosis, the greater the chances of having preterm delivery. Pregnancies in the first trimester (first three months) have the lowest risks.
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