Am J Surg. 2024 Nov 28;240:116120. doi: 10.1016/j.amjsurg.2024.116120. Online ahead of print.
ABSTRACT
BACKGROUND: Reported outcomes after appendectomy during pregnancy remain inconclusive, and the risk for preterm delivery is not necessarily procedure-related.
METHODS: This retrospective cohort study included 185 pregnant women who underwent appendectomy during pregnancy and gave birth between 2005 and 2022, compared using a 3:1 ratio to 555 parturients who did not undergo surgery. clinical, obstetrical and neonatal outcomes were analyzed.
RESULTS: Laparoscopic appendectomy was the most common procedure (117/185; 63.2 %) whereas 68/185 (36.8 %) had open appendectomy. Pathological findings revealed that 141/185 cases (76.2 %) had an inflamed appendix, while 44/185 (23.8 %) were classified as having a “white appendix” (negative appendectomy). Preterm delivery occurred more frequently in the appendectomy group [22/185 (11.9 %) vs 30/555 (5.4 %), p = 0.003] with even higher incidence in negative appendectomies compared to inflamed appendix cases [9/44 (20.5 %) vs 13/141 (9.2 %), p = 0.044]. Multivariate analysis identified appendectomy (but not an inflamed appendix) as the sole significant risk factor for preterm birth (odds ratio 2.3, CI 1.26-4.15, p = 0.006).
CONCLUSION: Preterm delivery correlates with negative appendectomies. Careful assessment is essential to avoid unnecessary surgical interventions during pregnancy.
PMID:39632335 | DOI:10.1016/j.amjsurg.2024.116120
