Evaluation of obstetrical and fetal outcomes in pregnancies complicated by acute appendicitis.
OBJECTIVE
The purpose of our study was to evaluate obstetrical and fetal outcomes in pregnancies complicated by acute appendicitis, and to specifically evaluate the impact of peritonitis.


METHODS
We conducted a population-based cohort study using the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample from 2003 to 2010 to evaluate perinatal outcomes in pregnant patients with appendicitis and delivery in the same admission compared to women delivering without appendicitis. Logistic regression was used to calculate the odds ratio (OR) and corresponding 95 % confidence intervals (CIs) for variables and outcomes of interest.


RESULTS
Among seven million maternities, there were 1,203 women with appendicitis who delivered in the same admission. Pregnant women with appendicitis were more likely to deliver preterm OR 2.68 (95 % CI 2.31-3.11) and had an increased risk in abruptio. Among the 27 % of patients with peritonitis, the rate of preterm birth was fourfold higher, and the caesarean section rate was almost doubled.


CONCLUSIONS
Although rare, appendicitis in pregnancy is associated with adverse maternal outcomes and worsened in cases of peritonitis. Measures to decrease risk of peritonitis should be taken in order to limit associated morbidities.
Department of Obstetrics and Gynecology, Jewish General Hospital, 5790 Cote-Des-Neiges Road, Pav H, Room 325, Montreal, QC, H3S 1Y9, Canada.
Nimrah
N
Abbasi
Valerie
V
Patenaude
Haim A
HA
Abenhaim
D000037:Abruptio Placentae / Q000453:epidemiology; D000328:Adult; D001064:Appendicitis / Q000453:epidemiology*; D016022:Case-Control Studies; D002585:Cesarean Section / Q000706:statistics & numerical data; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D010538:Peritonitis / Q000453:epidemiology; D006473:Postpartum Hemorrhage / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult