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.