Strengths and limitations
We interpret our results in the light of the inherent limitations of the retrospective design of the study, but comparisons have been made with comparable cohorts both with respect to pregnant women without appendicitis and non-pregnant women with appendicitis. The IR are subject to substantial fluctuations, and clinically important complications are rare. However, due to the devastating consequences of late pregnancy foetal complications, the present results contribute to an updated perspective on the risks and complications of appendectomy during pregnancy. Although not included in our local management guidelines, we could not exclude non-operative antibiotic treatment for appendicitis in pregnancy, especially close to delivery [15,18].
In conclusion, appendectomy during pregnancy requires extra care to avoid complications for both mother and the unborn child. An active approach with a low threshold for surgery increases the risk of negative findings, but this a low price for avoiding a perforated appendix and an increased risk of fetal loss and preterm delivery.