Appendectomy in pregnancy: evaluation of the risks of a negative appendectomy

Am J Surg. 2012 Feb;203(2):145-50. doi: 10.1016/j.amjsurg.2011.02.010. Epub 2011 Jul 23.


Background: In pregnant women, a high negative appendectomy (NA) rate often is reported; however, the outcome of pregnancy after a NA is not well studied.

Methods: Among 1,696 consecutive patients (728 men and 968 women) who underwent an appendectomy at our institution (1996-2005), 87 pregnant women were identified. Postoperative surgical and obstetric outcomes were analyzed based on the final pathologic report of the appendix (normal appendix, inflamed, or perforated).

Results: The NA rate was significantly higher in pregnant women compared with nonpregnant women (36% vs 14%; P < .05). The fetal demise rate was similar between the NA group and the inflamed group (3% vs 2%; P = NS), and highest (14%) in the perforated group, although this difference did not reach statistical significance (P = .3). Wound infections were most frequent in the perforated group (P < .05).

Conclusions: NA during pregnancy is not free of risk to the fetus. We recommend careful assessment to avoid unnecessary exploration when appendicitis is suspected in pregnant women.

MeSH terms

  • Abortion, Spontaneous / etiology
  • Adolescent
  • Adult
  • Appendectomy*
  • Appendicitis / diagnosis
  • Appendicitis / surgery*
  • Case-Control Studies
  • False Positive Reactions
  • Female
  • Fetal Death / etiology
  • Humans
  • Male
  • Postoperative Complications*
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / surgery*
  • Premature Birth / etiology
  • Retrospective Studies
  • Risk
  • Surgical Wound Infection
  • Young Adult