Appendicectomy while pregnant: What you need to know

The article is professionally consulted by a Doctor of Obstetrics and Gynecology - Vinmec Central Park International General Hospital.

Appendicitis pain is one of the early warning signs of appendicitis or appendicitis. Appendicitis can occur at any age from infancy to adulthood, even to pregnant women.

The appendix is ​​the first part of the large intestine, a small organ located in the right iliac fossa area of ​​the abdomen. When the appendix becomes blocked by the long-term accumulation of waste, it causes inflammation that leads to appendicitis pain.
Appendiceal pain is one of the common clinical conditions, which is one of the signs suggestive of an acute condition of the appendix.
Appendiceal pain often occurs in appendicitis or in cases of appendicitis.

Manifestations of appendicitis pain:
Location: Appendiceal pain often appears in the right iliac fossa, may begin with pain in the entire abdomen, then localize to the right iliac fossa, in some cases pain in the lower umbilicus, sometimes in special cases in the early days of the disease, the patient has pain in the left iliac fossa, so it is easy to mistake it for diseases of the colon. Pain nature: Appendicitis pain usually comes on suddenly, is severe, most patients have pain that increases over time in the range of 6-24 hours. In mild cases, appendicitis pain is insidious, persisting for a long time. Accompanying symptoms: Accompanied by appendicitis pain are often some symptoms of digestive disorders such as vomiting, nausea, diarrhea, poor appetite, pale fatigue, sometimes bladder pain. optic or urinary tract problems.

In pregnant women, in addition to difficulties in living when the fetus is growing, the mother also has to endure many other feelings in the body changes caused by the fetus such as back pain, vomiting. continuously due to pregnancy, poor eating, abdominal pain, fever, diarrhea, discomfort and tension in the bladder area... Therefore, appendicitis in pregnant women is often difficult to recognize and easy to diagnose. Mistaken with other problems of pregnancy, leading to late diagnosis and delayed treatment. Pregnant women, especially from 33 weeks of gestation onwards, the faster the fetus grows in terms of stimulation and weight, causing the abdominal cavity. gradually narrowing, appendix and cecum are pushed up, pressing out of the abdominal wall, so the symptoms become more complicated, making it difficult to diagnose appendicitis. At this time, to make an accurate diagnosis, it is necessary to rely on subclinical tests such as blood count, magnetic resonance imaging...

Clinically, to treat appendicitis in pregnant women, there are 2 methods: drug treatment and surgery. The method of antibiotic treatment is only applied to cases of mild inflammation and has not yet affected the mother's health, and have not shown signs of complications due to appendicitis.
However, in reality, there are many cases of appendicitis that do not respond to antibiotics, or severe cases of inflammation that have a risk of complications from rupture of the appendix causing hemorrhagic effusion. will cause danger to both mother and fetus that can lead to amniotic fluid infection, intestinal adhesions, premature birth, miscarriage... At this point, appendectomy is mandatory even if the patient is pregnant. .
Depending on the level of inflammation, gestational age and the health of the mother and child, the doctor may prescribe laparoscopic or open surgery. In the case of laparoscopic surgery, the surgical technique will have little effect on the fetus. After surgery, it is necessary to monitor for complications because complications may occur in the first 3 days after surgery. For open surgery, doctors need to be very careful before, during and after surgery so as not to affect the pregnancy.

Notes for follow-up after appendectomy:
Monitor complications as well as patient progress, especially in the first 3 days after surgery. If the pregnancy is over 24 weeks, pay special attention to the fetus's reaction to surgery. Clinically, 80% of surgical patients will experience uterine contractions and about 5-14% of patients with appendicitis will deliver prematurely. Therefore, after surgery, pregnant women should have appropriate follow-up care, follow the instructions and instructions of the treating doctor to avoid affecting the pregnancy as well as the health of both mother and child. After an appendectomy, the appendectomy is not associated with a cesarean section or vaginal delivery. Appendicitis pain is one of the conditions that are classified as surgical emergencies, potentially causing acute pathology of the appendix, which can affect the patient's health. In pregnant women, the diagnosis of appendicitis is sometimes difficult and is easily confused with other phenomena of pregnancy. Therefore, during pregnancy, if you have abnormal abdominal pain, especially pain in the right pelvic area accompanied by fever, vomiting, etc., you should not self-medicate, go to a specialist doctor immediately for advice. Timely examination and treatment to avoid affecting the pregnancy and the health of both mother and fetus.