Alaarabiou A*, Rabbani K, Louzi A and Finech B
Acute appendicitis is the most common nonobstetric surgical emergency during pregnancy. Its occurrence during pregnancy exposes it to additional diagnostic difficulties and transforms the current pregnancy into a pregnancy at risk. Our series includes 33 cases of acute appendicitis and pregnancy. The objective of the study is to describe the characteristics of acute appendicitis in pregnant women. In terms of epidemiology most studies find a predominance of primary patients with acute appendicitis, in our study it was more the multipares. The age of onset of acute appendicitis is between 18 and 44 years of age so there is a larger proportion of onset in the second trimester of pregnancy. Despite the many possible tables, the most constant sign of examination at any stage of pregnancy remains the pain caused at the level of the right iliac fossa and this despite the migration of the appendix. Biology is only an additional diagnostic tool that does not alone affirm or deny the diagnosis. Ultrasound may specify, correct or support a suspected diagnosis. The scanner is not without danger, but its high performance may, in case of questionable clinical presentation, be of valuable help. During the operation any hypoxia, hypotension, hypertension, acidosis, hypo or hyperventilation should be avoided. Coelioscopy adds other risks related to pneumoperitin. Coelioscopic surgery during pregnancy and in particular appendicectomy has many advantages over laparotomy and seems to be safe for more and more advanced stages of pregnancy. The use of tocolytic agents must be case-specific, its indications are not consensual and their effectiveness in prophylactic measurement is not demonstrated. In our context, there is no place for coelioscopic surgery for appendectomy during pregnancy and laparotomy takes its place. Appendicitis and pregnancy are a high-risk maternal-fetal association whose prognosis depends on the early diagnosis and therapeutic management.
Published Date: 2022-07-26; Received Date: 2019-10-03
