What are the clinical characteristics of appendicitis in pregnant women?

Appendicitis in pregnant women is also known as gestational appendicitis. It is mainly caused by inflammation of the appendix due to the pregnant woman's own physical condition during pregnancy. Pregnancy is a special period. Since the fetus is constantly developing, there are many conditions that may occur on its own. For the health of the child, expectant mothers should pay more attention and actively prevent various diseases. Try to give your child a healthier body. Don’t be nervous if you suffer from appendicitis during pregnancy. Let’s take a look at the clinical characteristics of appendicitis in pregnant women.

Under the influence of pregnancy hormones, local inflammatory reactions are suppressed, and blood levels of adrenal cortical hormones increase 4 times during pregnancy. High concentrations of hormones can mask the symptoms and signs caused by inflammation, which can easily delay diagnosis and treatment. The abdominal wall muscles relax during pregnancy, and the appendix is ​​covered by the uterus and away from the abdominal wall. Rebound pain and muscle tension are often not obvious, which can easily interfere with the judgment of the condition, leading to appendicitis perforation and severe peritonitis. The cecum and appendix are displaced during pregnancy, causing twisting, adhesions, appendix ischemia and obstruction of the appendix cavity, which leads to appendicitis suppuration and perforation.

During pregnancy, appendicitis can easily spread and develop rapidly, with the incidence of perforation reaching 28% in the middle stage and 42% in the late stage. The reason is that the enlarged uterus pushes the appendix from the right lower abdomen upward and backward, and the inflammation is easy to spread in the abdominal cavity; during pregnancy, the pelvic blood vessels increase, congestion is obvious, the appendix is ​​also congested, the inflammation is easy to spread with the blood, develop rapidly, and appendix necrosis and perforation are prone to occur; the enlarged uterus pushes the greater omentum, blocking and hindering the greater omentum from moving towards and wrapping the lesion area, and the appendix inflammation is not easy to be localized; fetal movement and uterine contraction destroy the protective adhesions caused by inflammation, so that the inflammation cannot be wrapped and confined, or the already confined inflammatory lesions spread again, resulting in diffuse peritonitis.

In early pregnancy, because the uterus is small, the symptoms and signs of appendicitis are the same as those of general patients. Fever, nausea, vomiting, and abdominal pain may occur. Physical examination may reveal abdominal tenderness, rebound tenderness, muscle tension, and elevated blood counts. But the nausea and vomiting caused by acute appendicitis can easily be considered a common reaction to pregnancy. In the second trimester of pregnancy, as the uterus enlarges, the appendix may shift upward and inward, and the abdominal pain and tenderness caused by appendicitis are often located higher. Late in pregnancy, the enlarging uterus shifts further up and toward the flank, making symptoms and signs more atypical. During labor, uterine contraction pain is more difficult to distinguish from the abdominal pain caused by appendicitis during pregnancy. Appendicitis during pregnancy can present with different clinical symptoms depending on the stage of pregnancy at which it occurs.

Appendicitis is not a difficult disease. Its biggest characteristic is abdominal pain. The incidence of appendicitis is relatively fast, and it is contagious and can infect other parts of the body. In order to prevent appendicitis in pregnant women, they need to go to the hospital for regular prenatal check-ups.