RCOG World Congress 2025

Multidisciplinary Insights into Acute Appendicitis in Pregnancy: A 10-Year Retrospective Study
S. Garg, A. Shirazi, S. Malhotra, V. Sharma,T. Wai, Colchester Hospital, UK

•10-year retrospective study

•Multicentre MAMA program

•Colchester Hospital

●Eligibility Criteria

●1)Pregnant patients aged ≥18 years diagnosed with acute appendicitis (clinically, radiologically, histologically, or intra-operatively),

●2)Diagnosis or surgery occurred between October 2013 and September 2023.

●3)Clinical diagnoses must have been made by a general surgical team member.

CONCLUSION :

Acute appendicitis in pregnancy poses significant diagnostic and management challenges due to its symptom overlap with obstetric conditions.

Laparoscopic appendicectomy emerged as the preferred approach, with timely intervention essential to reducing risks.

While leucocytosis is a common finding in appendicitis, its diagnostic value in pregnancy is limited due to mild leucocytosis being typical.

Delays in surgery were linked to worse outcomes. G

iven the low sensitivity of ultrasound, maintaining a low threshold for employing a secondary imaging modality (MRI) is vital. Pregnancy outcomes revealed significant risks, with 15% resulting in adverse events: one early miscarriage at 9 weeks, one late miscarriage at 20 weeks, and one preterm delivery at 33 weeks. Delays in diagnosis contributed to adverse outcomes in two cases. Despite these complications, most patients (80%) had term live births. However, 8 cases (40%) involved SGA infants, highlighting the potential impact of delayed or complicated appendicitis management on fetal growth. These findings emphasise the critical importance of timely diagnosis and intervention to minimise risks and improve maternal and fetaloutcomes.

RCOG World Congress 2025

Multidisciplinary Insights into Acute Appendicitis in Pregnancy:A 10-Year Retrospective Study

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