What are clinical features?
Appendicitis often manifests atypically in pregnant individuals, potentially delaying diagnosis.
Atypical (higher) pain localization
Other possible symptoms include heartburn, flatulence, irregular bowel movements, diarrhea, urinary frequency, and pain on Douglas pouch palpation.
List diagnostics.
Laboratory studies: Results may be misleading due to physiological changes in pregnancy.
Graded compression ultrasonography
An ultrasonographic technique in which the transducer is used to gradually compress the abdominal wall, which displaces the bowel to better visualize intraabdominal structures.
Can be used to diagnose appendicitis in children and pregnant individuals.
If ultrasonography is inconclusive, consider MRI.
Describe the treatment.
prompt laparoscopic or open appendectomy
Delayed intervention (> 24 hours) after symptom onset is associated with a higher risk of perforation.
Laparoscopic approach is safe and can be performed in all trimesters. [62]
Perioperative antibiotics with proven coverage of gram-negative and anaerobic bacteria
List complications.
Maternal: cervical incompetence, vaginitis, vulvovaginitis, sepsis
Fetal: small for gestational age, low birth weight
A perforated appendix is associated with a higher risk of preterm labor and pregnancy loss.
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