Acute Appendicitis During Pregnancy

The records of 38 patients who were pregnant and underwent operations for suspected appendicitis in Ogaki Municipal Hospital during the 11-year period from 1973 to 1983 were reviewed, and the findings were compared with those of 1, 180 nonpregnant women in a similar age group who were operated on for suspected appendicitis during the same period. The diagnosis of appendicitis was established in 31 of the 38 patients (81.6%). The clinico-pathological types of acute appendicitis were simple acute in 17 cases, phlegmonous in 12 cases and perforated in 2 cases. There were no differences in the incidence of perforation of the appendix between pregnant and non pregnant patients. In most pregnant patients, abdominal pain and maximum tenderness were in the right lower quadrant and the region of maximum tenderness coincidented with the actual position of the appendix. In the incidence of vomiting, temperature elevation over 37.5°C, and rebound tenderness, or muscle spasm, clinically significant difference between pregnant and nonpregnant patients was not apparent, but the incidence of leukocytosis over 10, 000/mm3 in pregnant patients was more than that in nonpregnant patients. Progesteron or a β2 stimulant was employed for prevention of premature labor, but two patients (acute simple type, acute suppurative salpingitis) aborted postoperatively. Three patients underwent artificial abortions. Twenty-three patients whom we followed up completely, bore full-term infants without abnormalities.