Navigating Acute Appendicitis in Pregnancy: Challenges and Strategies

Introduction: Acute appendicitis is one of the most common surgical emergencies worldwide, and its occurrence during pregnancy presents unique challenges for both diagnosis and management. Objectives: The main objective of the study is to find the challenges and strategies adopted in acute appendicitis during pregnancy. Methodology: This prospective study was conducted at Bolan University of Medical and Health Sciences, Quetta during February 2023 to February 2024. A total of 135 pregnant patients diagnosed with acute appendicitis were included in this study. Retrospective data were collected from the medical records of pregnant patients diagnosed with acute appendicitis over the past five years. This included detailed information on patient demographics, clinical presentations, diagnostic procedures, treatment methods, and outcomes. Results: The study included a total of 135 pregnant patients diagnosed with acute appendicitis. The patients' ages ranged from 18 to 42 years, with a mean age of 28 years. The gestational age at diagnosis varied, with the first trimester accounting for 25% of cases, the second trimester 45%, and the third trimester 30%. Ultrasound was used as the primary imaging modality in 120 cases (89%). It successfully confirmed the diagnosis in 100 cases (83.3%), while 20 cases (16.7%) required further imaging with MRI. Complications were observed in 20 patients (14.8%). These included wound infections (10%), minor bleeding (3%), and prolonged hospital stay (1.8%). There were no maternal deaths. Adverse fetal outcomes were noted in 15 cases (11.1%). Conclusion: It is concluded that managing acute appendicitis during pregnancy requires a careful, multidisciplinary approach. Early and accurate diagnosis using ultrasound and MRI is critical, and laparoscopic appendectomy is the preferred treatment when feasible.