Comparison of the demographic and clinical features of pregnant and non-pregnant patients undergoing appendectomy

BACKGROUND: This retrospective study aims to compare the demographic and clinicopathological characteristics of the pregnant and non-pregnant patients who underwent appendectomy with a presumed diagnosis of acute appendicitis.
METHODS: Between June 2009 and January 2019, 431 reproductive-aged of female patients underwent appendectomy with a presumed diagnosis of acute appendicitis. Patients were divided into two groups considering their pregnancy status: pregnant group (n=48) and non-pregnant group (n=383). Both groups were compared with respect to demographic, clinical and histopathological features.
RESULTS: No statistically significant difference was found between pregnant and non-pregnant groups except total bilirubin level (p=0.019) and ultrasonographic findings (p=0.016). In the non-pregnant group, negative appendectomy and perforation rates were 26% and 10.5%, where these rates for the pregnant group were 20.8% and 4.2%. Sensitivity, specificity and accuracy rates of ultrasonography for the pregnant group were 50%, 100% and 58.5%, where these rates for the non-pregnant group were 67.3%, 57.9% and 65%. The pregnancy date was the first trimester in 52.1%, the second trimester in 29.2% and the third trimester in 16.7% of the pregnants. None of the term births (87.5%) resulted in neither a fetal nor a maternal complication. However, 12.5% of the preterm births resulted in neonatal mortality.
CONCLUSION: Although not statistically significant, this study points out relatively lower rates of negative appendectomy and perforated acute appendicitis among pregnant patients, which is related to the overly attentive evaluation of pregnants admitted due to acute abdomen.

Apendektomi yapýlan gebe ve gebe olmayan hastalarýn demografik ve klinik özelliklerinin karþýlaþtýrýlmasý

AMAÇ: Bu retrospektif çalýþma akut apandisit ön tanýsýyla apendektomi yapýlan gebe ve gebe olmayan hastalarýn demografik ve klinikopatolojik özelliklerini karþýlaþtýrmayý amaçlamaktadýr.
GEREÇ VE YÖNTEM: Haziran 2009 ve Ocak 2019 tarihleri arasýnda üreme çaðýndaki 431 kadýn hastaya akut apandisit ön tanýsýyla apendektomi yapýldý. Hastalar gebelik durumlarý gözönünde bulundurularak iki gruba ayrýldý: Gebe grup (n=48) ve gebe olmayan grup (n=383). Her iki grup demografik, klinik ve histopatolojik özellikler yönünden karþýlaþtýrýldý.
BULGULAR: Gebe ve gebe olmayan gruplar arasýnda total bilirubin (p=0.019) ve ultrasonografik bulgular (p=0.016) dýþýnda istatistiksel olarak anlamlý farklýlýk saptanmadý. Gebe olmayan grupta negatif apendektomi ve perforasyon oranlarý sýrasýyla %26 ve %10.5 olarak hesaplanýrken gebe grupta bu oranlar sýrasýyla %20.8 ve %4.2 olarak hesaplandý. Ultrasonografinin gebe grubundaki sensistivite, spesifisite ve doðruluk oranlarý sýrasýyla %50, %100 ve %58.5 olarak saptanýrken gebe olmayan grupta bu oranlar sýrasýyla %67.3, %57.9 ve %65 olarak bulundu. Gebelerin %52.1’i birinci trimesterda, %29.2’si ikinci trimesterda ve geriye kalan %16.7’si üçüncü trimesterdaydý. Miadýnda gerçekleþen doðumlarýn (%87.5) hiçbirinde fetal veya maternal komplikasyon geliþmedi. Buna karþýn preterm gerçekleþen doðumlarýn (%12.5) ikisi neonatal mortalite ile sonuçlandý.
TARTIÞMA: Ýstatistiksel olarak anlamlýlýk göstermemekle birlikte gebelerde negatif apendektomi ve perfore akut apandisit oranlarý gebe olmayan hastalara göre daha düþük bulundu ki bu durumun en önemli sebebi akut karýn ile baþvuran gebelerin klinik olarak daha hassas bir þekilde deðerlendirilmesidir.