The Clinical Course of Acute Appendicitis During Pregnancy: Comparison of Reproductive Age Patients and Pregnant Patients

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Another subgroup that creates diagnostic difficulties for the clinician is pregnant patients.During pregnancy, acute appendicitis is the most common non-obstetric pathology that requires surgical intervention.9 The diagnosis is more challenging due to anatomical and physiological changes during pregnancy.10 It is known that both delayed cases and unnecessary operations increase maternal and fetal morbidity.11 Therefore, it is important to make an accurate diagnosis in pregnant women.Traditional teaching states that there is an increased risk of complications in pregnant patients with acute appendicitis.12,13 Recent studies indicate ABSTRACT Aim: The differential diagnosis of acute abdominal pain in women of reproductive age is challenging.Acute appendicitis is the most common cause of acute abdomen during pregnancy.This study aimed to compare pregnant women with nonpregnant women of reproductive age in terms of diagnostic approach, clinical management, and surgical outcomes in acute appendicitis and to identify any differences occurring in pregnant patients.Method: Female patients aged between 18-45 years, who underwent appendectomy between January 2015 and December 2018 were included in this retrospective study.Pregnant and non-pregnant patients were compared in terms of clinical presentation, management, and outcomes.Results: A total of 277 patients (28 pregnant and 249 non-pregnant) were included.In terms of diagnostic imaging, ultrasound was used in all pregnant patients, and 57.1% also underwent magnetic resonance imaging.In the non-pregnant group, computed tomography (CT) was used in 87.9%.There was a higher negative appendectomy rate in the pregnant group (21.4 vs 8.8%; p=0.038).Laparoscopic surgery was performed significantly more often in the non-pregnant group (21.4 vs 59.8%; p=0.001).Duration of diagnosis and length of stay was longer in the pregnant group.Both groups had similar rates of complicated appendicitis (7.1 vs 10.8%; p=0.416) and overall postoperative complications (14.2 vs 8.8%; p=0.316).Conclusion: The use of CT in the diagnosis of acute appendicitis was common in women of reproductive age.In pregnant women, negative appendectomy rates were higher.Clinical management and surgical outcomes were similar in pregnant women and non-pregnant women of reproductive age.

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