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J Matern Fetal Neonatal Med. 2015 Apr;28(6):727-33. doi: 10.3109/14767058.2014.932344. Epub 2014 Jul 2.

Single institution and statewide performance of ultrasound in diagnosing appendicitis in pregnancy.

Author information

1
Department of Surgery, University of Washington Medical Center , Seattle, WA , USA .

Abstract

OBJECTIVE:

Assess the performance of ultrasound (US) in pregnant patients presenting with acute abdominal pain concerning for appendicitis.

METHODS:

Descriptive analysis of pregnant patients who underwent an US for acute abdominal pain over a 6-year period using data from a statewide quality improvement collaborative and a single center.

RESULTS:

Statewide, 131 pregnant patients underwent an appendectomy and 85% had an US. In our single-center case series, 49 pregnant patients underwent an US for acute abdominal pain and four patients had appendicitis (8%). Of those, three were definitively diagnosed with US. The appendix was visualized by US in five patients (3 appendicitis/2 normal). Mean gestational age was 11 weeks for visualization of the appendix versus 20 weeks for non-visualization (pā€‰<ā€‰0.001). Concordance between US and pathology was similar statewide and at our institution (43%).

CONCLUSIONS:

US appears to play a central role in the evaluation of appendicitis in pregnant women, especially in the first trimester, and often contributes to definitive disposition. US performed less well in excluding appendicitis; however, in certain clinical settings, providers appeared to trust US findings. From these results, we developed a multidisciplinary imaging pathway for pregnant patients who present with acute abdominal pain concerning for appendicitis.

KEYWORDS:

Appendicitis; diagnostic imaging; pregnancy

PMID:
24913357
PMCID:
PMC4282618
DOI:
10.3109/14767058.2014.932344
[Indexed for MEDLINE]
Free PMC Article

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