The Significance of Clinical Signs and Blood Indices for the Diagnosis of Appendicitis during Pregnancy

Abstract

OBJECTIVE: To evaluate the significance of clinical signs and blood indices for the diagnosis of appendicitis during pregnancy. SAMPLE: Of the 40,112 women delivering at our institution (January 1995 to June 2002), 38 women (0.094%) were operated due to the suspicion of appendicitis during pregnancy. METHODS: Body temperature, clinical examination, white blood cell counts and lag time from arrival to operation were obtained for each patient. All women were operated with the clinical diagnosis of appendicitis, and their appendices were removed and examined by a pathologist. RESULTS: Inflammatory appendix was discovered in 19 (0.047%) of the pregnancies with subsequent deliveries while a normal appendix was found in 19 of the 38 (50%) appendices removed. The group with normal appendix did not significantly differ from women with inflamed appendix with regard to gestational age at presentation, signs of peritoneal irritation, body temperature, leukocyte count, time elapsed between arrival and surgery, gestational age at delivery and birth weight. CONCLUSIONS: The accurate diagnosis of appendicitis during pregnancy is a difficult task requiring a very high level of suspicion and clinical skills and not merely relying upon laboratory and classic signs.