Appendicitis in Pregnant Women: Diagnosis, Management, and Maternal-Fetal Outcomes

• DOI: https://doi.org/10.22533/at.ed.515721026140513

• Palavras-chave: Acute appendicitis; Pregnancy; Acute abdomen; Surgery during pregnancy; Maternal-fetal health.

• Keywords: Acute appendicitis; Pregnancy; Acute abdomen; Surgery during pregnancy; Maternal-fetal health.

• Abstract:

  Acute appendicitis is the leading cause of non-obstetric acute surgical abdomen during pregnancy, posing a significant diagnostic and therapeutic challenge due to the anatomical and physiological changes characteristic of the gestational period. Delayed diagnosis can result in serious complications, such as appendiceal perforation, sepsis, preterm delivery, and increased maternal and fetal morbidity and mortality. The present study aims to analyze the main aspects related to appendicitis in pregnant women, addressing pathophysiological factors, clinical manifestations, diagnostic methods, surgical treatment, and possible obstetric complications. This is a narrative review of the literature, conducted through the analysis of scientific articles published between 2013 and 2025 in the PubMed, Scielo, Google Scholar, and Virtual Health Library (VHL) databases. The results demonstrate that early diagnosis is hindered by the overlap between pregnancy-related symptoms and manifestations of appendicitis, in addition to the limitations of certain imaging tests during pregnancy. Ultrasound is the initial method of choice, while magnetic resonance imaging (MRI) has been gaining prominence due to its high diagnostic sensitivity and fetal safety. Surgical treatment remains the gold standard, with laparoscopic appendectomy considered safe in all trimesters of pregnancy when performed appropriately. It is concluded that early recognition of the disease and a multidisciplinary approach are essential for reducing maternal and fetal complications, ensuring a better prognosis for both mother and fetus.