How Appendicitis is Diagnosed in Pregnancy

Appendicitis in pregnant women may be difficult to diagnose because it occurs with the typical symptoms of pregnancy, such as nausea, vomiting, and abdominal pain. This complicated diagnosis often results in perforation, which can be ominous for the expectant mother or fetus.

It is therefore imperative that urgent medical attention be sought if appendicitis is detected in pregnancy.

What is Appendicitis in Pregnancy?

Appendicitis is a condition in which the appendix becomes inflamed and infected. The appendix is a small, slender pouch located on the right side of your lower abdomen. It is possible, though rare, to recover from appendicitis without surgery. However, the majority of people will require surgery to remove their appendix. Appendectomy is the medical term for this procedure.

During pregnancy, there is a higher risk of diseases, infection, and complications from appendicitis. Due to the similarities of its symptoms with a normal pregnancy and challenges with diagnosis, appendicitis in pregnancy can result in a higher chance of perforation, which can be harmful to the mother and fetus.

Appendicitis during pregnancy appears to be prevalent during the first and second trimesters. When appendicitis is not properly treated during pregnancy, it can lead to peritonitis (an infection in the abdominal cavity). There is an increased risk of preterm delivery and stillbirth due to these difficulties.

What are the Symptoms of Appendicitis in Pregnancy?

During pregnancy, the uterus expands, and the ligaments are stretched, which causes abdominal pain. It is still difficult to confirm the diagnosis of appendicitis by looking for symptoms that are unusual to normal pregnancy, such as stomach pain, nausea, and vomiting.

In pregnancy, the appendix moves, and the bowel gets dislodged as the uterus grows. An abdominal examination might not be able to identify abdominal pain. The pain can radiate to the upper right side of the abdomen as the gestational age increases, and the location of the appendix can change.

You may also experience other symptoms besides abdominal pain like loss of appetite, nausea, flatulence, and abdomen tenderness. In addition, fever and chills can result from an infection of the appendix.

How Appendicitis is Diagnosed in Pregnancy?

When it comes to appendicitis in pregnant women, highly experienced and specialized doctors are needed to obtain a correct diagnosis instead of patients with lower right abdominal pain in general.

An ultrasound is typically the first recommendation when a pregnant woman arrives at Post Oak ER with symptoms suggesting appendicitis. However, the best way to diagnose an appendix in a pregnant patient is using MRI because ultrasound does not enable viewing the appendix.

How to Prepare Before Treatment?

After an accurate diagnosis, surgery will be recommended. But before the surgery, the pregnant woman must avoid self-medication to relieve the pain. If emergency surgery is required, the intake of food and liquids must be restricted.

How Appendicitis is Treated in Pregnancy?

Pregnant women who have appendicitis usually need to have the appendix surgically removed.

With the help of an obstetrician and gynaecologist, surgeons plan surgical treatment together to optimize recovery from appendicitis while pregnancy is considered healthy.

In addition, c-sections are not required in most cases. Although each individual’s treatment plan is unique, it depends on the severity, complications, and health status.

Appendicitis Surgery

There is an increased chance of ruptured appendicitis in pregnant women that leaks infection into the abdomen, resulting in sepsis. Therefore, immediate surgery is necessary.

Appendectomy is a surgical procedure that removes the appendix. An appendectomy can be performed openly or laparoscopically. Due to its superior benefits, the latter is increasingly used.

Laparoscopic appendicitis is a minimally invasive procedure that uses small incisions to remove the appendix compared to an open appendectomy that requires an open incision.

Gynaecologists, surgeons, and obstetricians insert surgical instruments and surgical cameras (laparoscopes) through these small incisions while monitoring enlarged images of the internal organs on monitors.

There are several reasons for choosing laparoscopic appendectomy over open surgery, including a smaller incision size, less blood loss, little or no pain and scarring, quick recovery time, and fewer postoperative complications, such as a reduced infection rate. Furthermore, advanced surgical technology plays a crucial role in achieving the best possible surgical outcomes.


In determining the complexity of the laparoscopic procedure, the location of the appendix and the presence of complications are vital factors. It is more important to note that cutting-edge technology and multidisciplinary surgeons ensure the best outcomes.

In summary

Appendicitis in pregnancy can be fatal to both the mother and fetus if not given immediate attention. An accurate diagnosis is necessary so that timely treatment can commence.

Post Oak ER is here to help, and we have a board-certified team on hand that includes obstetricians and gynaecologists, surgeons, and emergency-ready medical professionals.