[Acute appendicitis in pregnancy]

Abstract

A retrospective analysis of acute appendicitis during pregnancy in patients seen at the Surgical Service of Ribeirão Preto between December 1959 and December 1988 showed that out of 18,065 deliveries performed there were 7 cases of acute appendicitis (0.038%). Gestational age in which acute appendicitis developed varied from the 11th to the 27th week, the second trimester prevailing. Both in pregnant and in non-pregnant patients, clinical history of appendicitis was similar, except for a few cases in which the cecum, mobile as it is, caused localized pain in a more cranial position. Acute appendicitis during pregnancy showed a more aggressive evolution and despite a period lower than 24 hours, only two of our patients did not exhibit a purulent secretion in the abdomen during surgery. The two patients with a prolonged time of history had necrosed and perforated appendices. There was no maternal mortality. Among complications observed, wall abscess (14%), adynamic ileum (14%), and premature labor (28%) were the most important. Inhibition was not possible in one of the cases of premature labor, with the birth of a live fetus on the second postoperative day. The fetus died eventually. Other patients gave birth to live and timely fetuses.