Appendicitis During Pregnancy: Causes, Symptoms, Diagnosis, and Management

Appendicitis is the most common non-obstetric surgical emergency during pregnancy. Diagnosing appendicitis in pregnant women is particularly challenging due to anatomical and physiological changes. Timely diagnosis and treatment are crucial to prevent maternal and fetal complications.

What is Appendicitis During Pregnancy?

Appendicitis is the inflammation of the appendix, a small finger-shaped pouch connected to the colon. During pregnancy, its presentation may mimic normal pregnancy symptoms such as nausea, vomiting, and abdominal pain, making diagnosis difficult.

Causes of Appendicitis in Pregnancy

• Obstruction of the appendix by fecoliths, parasites, or lymphoid hyperplasia
• Infections leading to appendix wall inflammation
• Increased intra-abdominal pressure during pregnancy
• Vascular compromise of appendix tissue

Symptoms of Appendicitis in Pregnancy

The symptoms vary depending on gestational age. Key warning signs include:

1. Right-sided abdominal pain – may shift upward as pregnancy progresses
2. Nausea and vomiting
3. Loss of appetite
4. Fever and malaise
5. Rebound tenderness on examination

Diagnosis of Appendicitis During Pregnancy

Diagnostic Method	Advantages	Limitations
Ultrasound	Safe in pregnancy, no radiation	Operator-dependent, limited visualization
MRI	High accuracy, safe for fetus	Expensive, limited availability
Blood Tests	Show raised WBC and CRP	Not specific for appendicitis

Complications of Untreated Appendicitis

• Miscarriage
• Preterm labor
• Fetal loss
• Peritonitis and sepsis in the mother

Treatment of Appendicitis in Pregnancy

1. Surgical Appendectomy – Standard treatment, performed laparoscopically or via open surgery depending on gestational age.
2. Antibiotics – Used as supportive therapy, not as definitive treatment.
3. Monitoring – Both maternal and fetal monitoring are essential post-surgery.

Prevention and Awareness

Appendicitis cannot always be prevented, but early recognition of symptoms and timely medical evaluation can significantly improve outcomes. Pregnant women should seek immediate care for persistent abdominal pain.

References

1. Andersen B, Nielsen TF. Appendicitis in pregnancy: Diagnosis, management and complications. Acta Obstet Gynecol Scand. 2021.
2. Society of American Gastrointestinal and Endoscopic Surgeons (SAGES). Guidelines for laparoscopic appendectomy in pregnancy. 2022.
3. American College of Obstetricians and Gynecologists (ACOG). Appendicitis in pregnancy clinical guidelines. 2023.

Disclaimer

This article is for educational and informational purposes only. It should not replace medical advice. Pregnant women experiencing abdominal pain should consult a qualified healthcare provider immediately.

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