Which of the following statements concerning appendicitis in pregnancy is true? (LQ)
|A||Diagnosis is similar to that in the non-pregnant patient|
|B||The maternal death rate is highest in the first trimester|
|C||Surgical treatment should be delayed until the diagnosis is firmly established|
|D||The incidence is unchanged by pregnancy|
The incidence is unchanged by pregnancy
1. The incidence of appendicitis in pregnancy is 1 in 2000, the same as that in the nonpregnant population.
2. The diagnosis is very difficult in pregnancy because leukocytosis, nausea, and vomiting are common in pregnancy and the upward displacement of the appendix by the uterus may cause appendicitis to simulate cholecystitis, pyelonephritis, gastritis, or degenerating myomas.
3. Surgery is necessary even if the diagnosis is not certain. Delays in surgery due to difficulty in diagnosis as the appendix moves up are probably the cause of increasing maternal mortality with increasing gestational age.
4. Pre mature birth and abortion account for a rate of fetal loss close to 15%.