Acute appendicitis in pregnancy, is there a role for conservative management?

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dc.contributor.authorTian, Jen_US
dc.contributor.authorAltai, Ten_US
dc.contributor.authorBhatia, Sen_US
dc.contributor.authorMourad, Yen_US
dc.contributor.authorMiele, Aen_US
dc.contributor.authorRobitsek, RJen_US
dc.contributor.authorMcKenzie, Ken_US
dc.contributor.authorLouis, MAen_US
dc.contributor.authorMandava, NRen_US
dc.date.accessioned2024-11-30T05:54:46Z
dc.date.available2024-11-30T05:54:46Z
dc.date.issued2024-04
dc.description.abstractBackground: Although rare, acute appendicitis is the most common general surgery problem encountered in pregnancy. A chief concern is timely and accurate diagnosis. Traditionally, delayed diagnosis of appendicitis in pregnant patients can quickly lead to appendiceal rupture associated with miscarriage, premature delivery, or even fetal loss. Hence, appendectomy has been the gold standard. However, emerging evidence suggests conservative management may be more effective than previously thought, after accounting for maternal and fetal characteristics. Methods: This retrospective study included a sample of pregnant women diagnosed with acute appendicitis presenting for treatment to two hospitals in Queens, NY, between Jan 2012 and Dec 2021. The characteristics, presentation, and outcomes of conservatively versus surgically treated patients were compared. Results: The cumulative incidence of acute appendicitis was 0.11% (n=44/28,000). Forty were treated surgically: 78% underwent laparoscopic appendectomy, 15% open appendectomy, and 8% underwent an initial laparoscopy which was converted to an open appendectomy. Four (14%) patients were managed conservatively with IV antibiotics. Eight percent of patients treated surgically had postoperative complications. Neither surgical nor conservatively treated groups reported any instance of mortality or fetal demise. Conclusions: Our study adds to the literature on treatment decisions for pregnant patients with acute appendicitis. Although surgical intervention remains the gold standard, it carries the potential risk of peri- and postoperative complications. These findings suggest conservative management with antibiotics can sometimes be used without a negative impact on maternal or fetal outcomes.en_US
dc.identifier.affiliationsDepartment of Surgery, Flushing Hospital Medical Center, Flushing, New York, USAen_US
dc.identifier.affiliationsDepartment of Medicine, UCSF Fresno, Fresno, California, USAen_US
dc.identifier.affiliationsDepartment of Surgery, Flushing Hospital Medical Center, Flushing, New York, USAen_US
dc.identifier.affiliationsNew York Institute of Technology, New York, USAen_US
dc.identifier.affiliationsDepartment of Research Education and Innovation, Medisys Health Network, New York, USAen_US
dc.identifier.affiliationsDepartment of Research Education and Innovation, Medisys Health Network, New York, USA; Department of Surgery, Jamaica Hospital Medical Center, Jamaica, New York, USAen_US
dc.identifier.affiliationsDepartment of Surgery, Jamaica Hospital Medical Center, Jamaica, New York, USAen_US
dc.identifier.affiliationsDepartment of Surgery, Flushing Hospital Medical Center, Flushing, New York, USAen_US
dc.identifier.affiliationsDepartment of Surgery, Flushing Hospital Medical Center, Flushing, New York, USAen_US
dc.identifier.citationTian J, Altai T, Bhatia S, Mourad Y, Miele A, Robitsek RJ, McKenzie K, Louis MA, Mandava NR. Acute appendicitis in pregnancy, is there a role for conservative management?. International Surgery Journal. 2024 Apr; 11(4): 567-572en_US
dc.identifier.issn2349-3305
dc.identifier.issn2349-2902
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/236106
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber4en_US
dc.relation.volume11en_US
dc.source.urihttps://doi.org/10.18203/2349-2902.isj20240746en_US
dc.subjectAcute appendicitisen_US
dc.subjectPregnanten_US
dc.subjectPregnancyen_US
dc.subjectSurgeryen_US
dc.titleAcute appendicitis in pregnancy, is there a role for conservative management?en_US
dc.typeJournal Articleen_US
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