Abstract:

Objective

To investigate the clinical characteristics，diagnosis，treatment，and pregnancy outcome of pregnancy complicated with acute appendicitis.

Methods

A retrospective study was conducted on 100 pregnant women with Suspected acute appendicitis.The patients were admitted to the Third Affiliated Hospital of Guangzhou Medical University from January 2008 to September 2023.Clinical characteristics，diagnosis，treatment，and pregnancy outcome of the patients were analyzed.According to the onset of gestational age，100 patients were divided into the early-pregnancy group（＜14 weeks）with 19 cases，the middle-pregnancy group（14-27⁺⁶ weeks）with 43 cases，and the late-pregnancy group（≥28 weeks）with 38 cases.

Results

（1）Clinical characteristics：All 100 patients presented with abdominal pain（100.00%），among which 88 cases had tenderness in the right lower abdomen（88.00%），and 66 cases had rebound pain（66.00%）.There were no statistically significant differences in the clinical symptoms and signs among the three groups of pregnant women（P ＞0.05）.（2）Auxiliary examination：There were no statistically significant differences in the white blood cell count，neutrophil count，and procalcitonin among the three groups of pregnant women（P ＞0.05）.The percentage of neutrophils in the late-pregnancy group was higher than that in the early-pregnancy group，and the difference was statistically significant（86.4% vs 80.3%，Z=6.890，P＜0.05）.67 cases underwent abdominal color Doppler ultrasound examination，and 33 cases underwent CT or MRI examination.There was no statistically significant difference in abdominal ultrasound，abdominal CT or MRI among the three groups of pregnant women（P ＞0.05）.74 cases underwent abdominal color Doppler ultrasound examination，11 cases underwent MRI examination，and 2 cases underwent CT examination.Additionally，16 cases received combined abdominal color Doppler ultrasound and MRI examinations，while 4 cases received combined abdominal color Doppler ultrasound and CT examinations.There were no statistically significant differences in the abdominal ultrasonography，abdominal CT，or MRI among the three groups of pregnant women（P ＞0.05）.（3）Treatment and pregnancy outcome：There were 36 cases of conservative drug treatment and 64 cases of surgical treatment.Among the 54 cases of abortion and delivery in our hospital，7 cases of abortion（12.96%），18 cases of vaginal delivery（33.33%），and 29 cases of cesarean section（53.71%）.The cesarean section rate of pregnant women in the early and middlepregnancy group was significantly lower than that of the late-pregnancy group，the difference was statistically significant（2/8 vs 6/15 vs 87.5%，χ²=14.309，P＜0.05）；the premature birth rate of pregnant women in the late-pregnancy group was higher than that of the early and middle-pregnancy groups，the difference was statistically significant（58.33% vs 2/8 vs 0，χ²=15.631，P＜0.05）.Among 47 neonates born in our hospital，there was no significant difference in neonatal asphyxia rate among the three groups（P ＞0.05）.

Conclusions

It is of paramount significance to comprehend the clinical traits of acute appendicitis in diverse gestational weeks and to accomplish early and accurate diagnosis and treatment for enhancing perinatal outcomes.

Key words: Pregnancy, Appendicitis, Abdominal pain, Diagnosis, Therapeutics, Pregnancy outcome