Unnecessary appendectomy risky in pregnant women

Unnecessary appendectomy risky in pregnant women
NEW YORK (Reuters Health) - Unnecessary surgery to remove anormal appendix during pregnancy increases the risk thatmom-to-be will lose her baby or that she will deliver early,research indicates.
"Since there is a risk of fetal loss and early delivery inpregnant women undergoing negative appendectomy, it appearsthat improved diagnostic accuracy is needed prior to takingpregnant women to the operating room for appendectomy," Dr.Marcia L. McGory, told Reuters Health.
"Neither ultrasound nor MRI have a harmful effect on thefetus and should probably be utilized more frequently inpregnant women to try to obtain a definitive diagnosis prior togoing to the operating room," she added.
McGory from the David Geffen School of Medicine at theUniversity of California Los Angeles and colleagues looked atthe outcomes of nearly 95,000 women who had their appendixremoved. More than 3,000 of the women were pregnant at the timeof surgery.
The researchers found that far more pregnant thannon-pregnant women had unnecessary appendectomies (23 percentversus 18 percent).
Among pregnant women, fetal loss rates were twice as highwith removal of a normal appendix (4 percent) than with simpleappendicitis (2 percent) and were increased further withcomplicated appendicitis (6 percent).
Early delivery rates were also higher after unnecessaryappendectomy (10 percent) and complicated appendicitis (11percent) than after simple appendicitis (4 percent), theresearchers note.
"There is definitely a need for further studies evaluatingpregnant women undergoing appendectomy," McGory said. The "moreliberal use" of pre-surgery imaging in pregnant women may helpconfirm the diagnosis prior to operation and reduce the numberof unnecessary operations performed, McGory suggested.
SOURCE: Journal of the American College of Surgeons,October 2007.