Appendicitis in the Pregnant Patient: Risk, Diagnosis, Management, and Outcomes

Purpose of Review To evaluate outcomes related to operative and non-operative management of appendicitis during pregnancy Recent Findings Several studies have evaluated preoperative laboratory values to improve the accuracy of diagnosis of appendicitis in the pregnant patient. Further, the Alvarado score appears to be accurate in the pregnant patient. Operative management continues to prevail in comparison to non-operative management consisting of antibiotics alone. Risks of preterm labor, fetal loss, and appendiceal perforation appear to be higher. Despite this, several recent studies have utilized MRI imaging to better stratify which patients may be better candidates for non-operative management. Additional future studies are still needed. Summary Appendicitis remains a common non-obstetric reason for abdominal pain during pregnancy. Perforation can result in poor outcomes. Operative management appears to be safe and is commonly utilized. Laparoscopy is a safe approach for surgeons who can perform laparoscopic appendectomy. Additional study is required to determine the role of non-operative management in the pregnant patient.