RT Book, Section
A1 Rogers, Vanessa L.
A1 Roberts, Scott W.
A2 Papadakis, Maxine A.
A2 McPhee, Stephen J.
A2 Rabow, Michael W.
A2 McQuaid, Kenneth R.
SR Print(0)
ID 1184182360
T1 Appendicitis in Pregnancy
T2 Current Medical Diagnosis & Treatment 2022
YR 2022
FD 2022
PB McGraw-Hill Education
PP New York, NY
SN 9781264269389
LK accessmedicine.mhmedical.com/content.aspx?aid=1184182360
RD 2024/04/23
AB Appendicitis  occurs  in  about  1  of  1500  pregnancies.  The  diagnosis  is  more  difficult  to  make  clinically  in  pregnant  women  where  the  appendix  is  displaced  cephalad  from  McBurney  point.  Furthermore,  nausea,  vomiting,  and  mild  leukocytosis  occur  in  normal  pregnancy,  so  with  or  without  these  findings,  any  complaint  of  right-sided  pain  should  raise  suspicion.  Imaging  can  help  confirm  the  diagnosis  if  clinical  findings  are  equivocal.  Abdominal  sonography  is  a  reasonable  initial  imaging  choice,  but  nonvisualization  of  the  appendix  is  common  in  pregnancy.  CT  scanning  is  more  sensitive  than  ultrasound,  and  with  proper  shielding,  the  radiation  exposure  to  the  fetus  is  minimized.  MRI  is  also  used  to  evaluate  for  appendicitis  in  pregnant  women  and  is  a  reasonable  alternative  to  CT  scanning.  Unfortunately,  the  diagnosis  of  appendicitis  is  not  made  until  the  appendix  has  ruptured  in  at  least  20%  of  obstetric  patients.  Peritonitis  in  these  cases  can  lead  to  preterm  labor  or  abortion.  With  early  diagnosis  and  appendectomy,  the  prognosis  is  good  for  mother  and  baby.