Methods for the diagnosis of acute appendicitis in pregnant women.

INTRODUCTION: Acute appendicitis (AA) is the most common non-obstetric surgical pathology during pregnancy. It is difficult to diagnose because of physiological changes. In our study, we aimed to define factors which are helpful in the diagnosis of AA.
METHODS: This study was started after obtaining permission from ethics committee in Yuzuncu Yil University. We collected the data retrospectively from the pregnant patients who underwent surgery between January 2013 and January 2018 with the diagnosis of AA. Demographic features, laboratory analyses, imaging modalities, intraoperative and postoperative pathologic findings were gathered. Final pathology was accepted as gold standard; the sensitivity and specifity of the investigated parameters were calculated. Z tests for two proportions were computed to compare proportions of AA in pregnant women.
RESULTS: From our study, the second trimester had been the most common surgery applied time (n=30, 49.2%). Although leukocytosis is seen in most patients (67.2%), there was no significant relationship between leukocytosis and AA.
In 51cases (83.6%) were suitable for AA from evaluation of operation material. In 33 cases (Alvarado score of 7 and above), pathology was suitable for acute appendicitis (positive predictive value = 89.2%). However, in 10 cases pathology was not suitable for AA (negative appendectomy rate was 16.4%).

DISCUSSION AND CONCLUSION: The most important result of our study is that; there is no valid diagnostic method in pregnant women for AA. We impress that the patient's history and physical examination is still the most important clinical parameter.