Appendicitis is a dangerous situation in pregnancy because its symptoms are slightly different and delayed diagnosis can break 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 manifest through persistent abdominal pain on the right side of the abdomen, around the navel and that may move to the lower part of the belly. At the end of pregnancy, during the third trimester of gestation, appendicitis pain may pass into the belly and ribs and may be confused with the common contractions at the end of gestation, making diagnosis difficult.
Place of appendicitis pain in pregnancy
Symptoms of appendicitis in pregnancy
The symptoms of appendicitis in pregnancy can be:
- Abdominal pain on the right side of the abdomen, near the iliac crest, but that 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 habits.
Other less common symptoms such as diarrhea, heartburn or excess intestinal gas may also appear.
The diagnosis of appendicitis is more difficult at the end of pregnancy because, because of uterine growth, the appendix may change position, with a higher risk of complications.
What to do in case of appendicitis in pregnancy
What should be done when the woman has abdominal pain that does not pass and a fever is to consult the obstetrician to make diagnostic tests, such as ultrasound of the abdomen, and to confirm the diagnosis, because the symptoms can also happen due to the changes of the 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 video-laparoscopic appendectomy. The preference is for the appendix to be removed from the abdomen by videolaparoscopy, reducing postoperative time and associated morbidity.
Laparoscopy is generally indicated for the first and second trimesters of gestation, whereas open appendectomy is restricted at the end of gestation, but it is up to the doctor to make this decision because there may be a risk of preterm birth, although most of the time gestation continues without problems for the mother and for the baby.
The pregnant woman should be admitted to the hospital for surgery and, after the procedure, stay under observation. The pregnant woman should go to the doctor's office every week to evaluate the healing of the wound and thus avoid possible maternal-fetal infections, ensuring a good recovery.
Learn more about surgery and post-operative care at:
Surgery for appendicitis
