title: The impact of pregnancy on the accuracy and delay in diagnosis of acute appendicitis.
abstract: OBJECTIVE
  To determine the accuracy and the delay in diagnosis of presumed acute appendicitis in pregnancy.
  
  
  METHODS
  Pregnant women undergoing appendectomy for presumed acute appendicitis were compared to non-pregnant age-matched women in a 3:1 ratio undergoing appendectomy in a tertiary medical center from 2001 to 2012.
  
  
  RESULTS
  Out of 1618 women who underwent appendectomy during the study period, 81 (4.2%) were pregnant who were compared to 243 age-matched non-pregnant women. There was a significantly shorter interval between admission to the hospital and surgery and shorter surgery length (10.2 versuss 15.7 h, 1.2 ± 0.4 versus 1.4 ± 0.5 h, respectively, p < 0.001) in the pregnant group with similar rates of negative appendectomy (19.8% versus 21.8%, respectively, p = 0.86). The positive and negative predictive values of ultrasonography (US) for the diagnosis of acute appendicitis were 88.2% and 100%, and 92.9% and 57.1%, among the pregnant and the non-pregnant group, respectively. In multivariate analysis, early gestational age was found to be independently associated with higher rate of accurate US results (OR = 0.92, 95% CI 0.85-0.99, p = 0.39).
  
  
  CONCLUSIONS
  Pregnant women undergoing appendectomy have shorter admission to surgery interval and surgical length with similar negative appendectomy rates compared to non-pregnant women. Ultrasound is an accurate tool for the diagnosis of acute appendicitis during pregnancy, especially during early gestation.
authors.affiliation: Helen Schneider Hospital for Women, Rabin Medical Center , Petach Tikva , Israel and.
authors.forename: Liran
authors.initials: L
authors.lastname: Hiersch
authors.forename: Yariv
authors.initials: Y
authors.lastname: Yogev
authors.forename: Eran
authors.initials: E
authors.lastname: Ashwal
authors.forename: Anat
authors.initials: A
authors.lastname: From
authors.forename: Avi
authors.initials: A
authors.lastname: Ben-Haroush
authors.forename: Yoav
authors.initials: Y
authors.lastname: Peled
mesh_terms: D000328:Adult; D001062:Appendectomy / Q000706:statistics & numerical data; D001064:Appendicitis / Q000000981:diagnostic imaging* / Q000601:surgery; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging* / Q000601:surgery; D012189:Retrospective Studies; D014463:Ultrasonography; D055815:Young Adult
keywords: Appendicitis; diagnosis; pregnancy