Appendicitis During Pregnancy: Best Surgical Practices and Clinical Management

Figures & data

Figure 1 ROC curves for diagnostic performance of appendicitis scoring systems in pregnant women.

Notes: Reprinted from Mantoglu B, Gonullu E, Akdeniz Y, et al. Which appendicitis scoring system is most suitable for pregnant patients? A comparison of nine different systems. World J Emerg Surg. 2020;15(1):34. Creative Commons.¹¹

Table 1 RIPASA Score for Acute Appendicitis

Parameter	Score
Sex
Male	1.0
Female	0.5
Age
<39.9 years	1.0
>40.0 years	0.5
RIF pain	0.5
Migration of RLQ pain	0.5
Anorexia	1.0
Nausea and vomiting	1.0
Duration of symptoms
<48 hours	1.0
>48 hours	0.5
RIF tenderness	1.0
RIF guarding	2.0
Rebound tenderness	1.0
Rovsing’s sign	2.0
Fever	1.0
Raised WBC	1.0
Negative urinalysis	1.0
Foreign NRIC	1.0

Figure 2 Example trocar placement (indicated by circles) in nonpregnant (A) and pregnant women in the third trimester (B).

Notes: Donkervoort S, Boerma D. Suspicion of Acute Appendicitis in the Third Trimester of Pregnancy: Pros and Cons of a Laparoscopic Procedure. 2011;15:379–383. Creative Commons.⁴³

Abbreviation: JSLS, Journal of the Society of Laparoendoscopic Surgeons/Society of Laparoendoscopic Surgeons.

Mantoglu B, Gonullu E, Akdeniz Y, et al. Which appendicitis scoring system is most suitable for pregnant patients? A comparison of nine different systems. World J Emerg Surg. 2020;15(1):34. doi:10.1186/s13017-020-00310-7

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Donkervoort S, Boerma D. Suspicion of acute appendicitis in the third trimester of pregnancy: pros and cons of a laparoscopic procedure. JSLS. 2011;15(3):379–383. doi:10.4293/108680811X13125733356837

 PubMed Web of Science ®Google Scholar