Symptoms and treatment of appendicitis in pregnancy

Appendicitis is a dangerous situation in pregnancy because its symptoms are slightly different and the delay in diagnosis can rupture the inflamed appendix, spreading feces and microorganisms in the abdominal cavity, leading to a serious infection which puts the life of the pregnant woman and the baby at risk.

The symptoms of appendicitis in pregnancy are manifested by persistent abdominal pain on the right side of the abdomen, around the navel, which can move to the lower belly. At the end of pregnancy, during the 3rd trimester of gestation, the pain of appendicitis can pass to the bottom of the belly and the ribs and can be confused with the common contractions at the end of pregnancy, making diagnosis difficult.

Local appendicitis pain in pregnancy

Appendicitis in the 1st trimester

Appendicitis in the 2nd and 3rd trimester

Symptoms of appendicitis in pregnancy

Symptoms of appendicitis in pregnancy can be:

Abdominal pain on the right side of the abdomen, near the iliac crest, but which may be slightly above this region and that pain may be similar to colic or uterine contraction.Low fever, around 38º C; Loss of appetite; There may be nausea and vomiting; Change in bowel habit.

Other less common symptoms may also appear, such as diarrhea, heartburn or an excess of intestinal gases.

The diagnosis of appendicitis is more difficult in late pregnancy because, due to uterine growth, the appendix can change position, with a higher risk of complications.

What to do in case of appendicitis during pregnancy

What should be done when the pregnant woman has abdominal pain and fever, is to consult the obstetrician to make diagnostic tests, such as abdominal ultrasound, and confirm the diagnosis, as the symptoms can also happen due to changes in pregnancy, without be a sign of appendicitis.

Treatment for appendicitis in pregnancy

The treatment of appendicitis in pregnancy is surgical. There are two types of surgery for appendix removal, open or conventional appendectomy and videolaparoscopic appendectomy. The preference is for the appendix to be removed from the abdomen by laparoscopy, reducing the postoperative time and the associated morbidity.

Usually laparoscopy is indicated for the 1st and 2nd trimesters of pregnancy, while open appendectomy is restricted to the end of pregnancy, but it is up to the doctor to make this decision because there may be a risk of premature delivery, although in most cases the pregnancy continues without problems for mother and baby.

The pregnant woman should be admitted to the hospital for surgery and after the procedure, be under observation. The pregnant woman should go to the doctor's office weekly to assess the healing of the wound and, thus, avoid possible maternal-fetal infections, ensuring good recovery.