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The Journal of the American Board of Family Medicine 19:621-626 (2006)
© 2006 American Board of Family Medicine

Clinical Review

Appendicitis in Pregnancy

Patricia A. Pastore, MSN, RN, FNP, Dianne M. Loomis, MSN, RN-CS, FNP and John Sauret, MD, FAAFP

Department of Family Medicine, The State University of New York at Buffalo, Buffalo, NY (PAP, JS)
Kaleida Health, Buffalo, NY (PAP, DML)
Niagara Falls Memorial, Niagara Falls, NY (JS)

Correspondence: Corresponding author: Patricia A. Pastore, Department of Family Medicine, The State University of New York at Buffalo, 462 Grider Street, Buffalo, NY 14215 (E-mail: pastore3{at}buffalo.edu)

Background: Our urban practice had two incidences of documented appendicitis in pregnancy in a 24-hour period with two unique outcomes that prompted an inquiry. Appendicitis in pregnancy is relatively rare, but it has significant morbidity and is a cause of maternal and infant mortality. Abdominal pain is the most common presenting symptom, and the consideration of multiple pathologic disorders should be entertained. Accurate diagnosis of appendicitis in pregnancy is the largest challenge since the signs and symptoms may vary depending on the trimester in which the patient presents.

Methods: We undertook a systematic review of English-language articles from 1975 to 2005 using the key words "appendicitis," and "pregnancy" using MEDLINE, CINAHL, and Cochrane Controlled Trials Register databases.

Results and Conclusions: The accurate diagnosis of appendicitis during pregnancy requires a high level of suspicion and clinical skills, and not merely relying on the classic signs and diagnostic testing. Primary care providers play an important role in recognizing potential signs and symptoms of appendicitis in pregnancy to initiate prompt action and reduce negative maternal and fetal outcomes.


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Copyright © 2006 by the American Board of Family Medicine.