Management of Complicated Appendicitis During Pregnancy Must

Till date we have sparse data regarding the optimal treatment for complicated appendicitis during pregnancy, hence a recent study in JAMA Network Open pointed out that immediate operation of appendicitis was associated with lower odds of infectious complications, including amniotic infection and sepsis, compared with successful and unsuccessful nonoperative management. When nonoperative management failed and required delayed operation, it was associated with significantly higher odds of preterm labor, preterm delivery, or abortion.

The cohort study Included pregnant women discharged with the diagnosis of complicated appendicitis. Study patients were categorized into 3 groups: those with successful nonoperative management, failed nonoperative management with delayed operation, or immediate operation for complicated appendicitis.

Among 8087 pregnant women with complicated appendicitis, nonoperative management of complicated appendicitis was successful among 11.8% and failed among 32.7%, who underwent delayed operation; 55.5% underwent immediate operation.

Hence, it was concluded that immediate operation for complicated appendicitis in pregnant women was associated with lower odds of maternal infectious complications without higher odds of perinatal or other maternal complications. Also, failed nonoperative management was associated with worse clinical outcomes.