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Gynaecology & Obstetrics Medical & Surgical Illness Complication Pregnancy feaae548

In a female with appendicitis in pregnancy treatment of choice is:

A
Surgery at earliest
B
Abortion with appendectomy
C
Surgery after delivery
D
Continue pregnancy with medical Rx
High-Yield Explanation
Ans. is a, i.e. Surgery at earliestRef Williams Obs. 24/e, p 1074Diagnosis of appendicitis during pregnancy is difficult as symptoms of appendicitis viz nausea, vomiting anorexia are normally present in pregnancy.But once the diagnosis is made immediate surgery should be done."If appendicitis is suspected, treatment is prompt surgical exploration. Even though diagnostic errors sometimes leads to removal of a normal appendix, it is better to operate than to postpone intervention until generalized peritonitis has developed."Route:Before 20 weeks- LaparoscopyAfter 20 weeks-Laparotomy (Incision should be made at McBurney's point)Earlier it was believed CO2 pneumoperitoneum created during laparoscopy can cause fetal acidosis and hypoperfusion, but now it is not so considered.

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