Appendicitis in Pregnacy

Q) Which of the following statement is true about appendicitis in pregnancy?

a) Typical symptoms of appendicitis  are seen in more than 90% of patients.

b) 50% cases of appendicitis occur in 2nd trimester

c) Rate of negative explorations remain low based on clinical presentation alone

d) The sensitivity and specificity of ultrasound diagnosis remain the same in appendicitis in pregnancy

Answer b

Appendicitis  the most common non obstetric emergency in pregnancy. The diagnosis is difficult because the symptoms of pain abdomen, nausea, vomiting, anorexia, raised TLC are common in pregnancy. Appendicitis has a typical presentation in only 50% to 60% cases.

If untreated preterm labor and even fetal loss can occur due to the complications.

Based on clinical presentation alone, the incidence of negative exploration is as high as 25-50%

Ultrasound with graded compression is still a good imaging option but has lower sensitivity and specificity than in normal clinical situation. If ultrasound is equivocal the next best option is MRI which is safe.

Ref Sabiston 20th edition