A number of cases over the past few years have highlighted the challenges of diagnosing appendicitis during pregnancy. Appendicitis can be difficult to diagnose in pregnant women. They are less likely to present with classic signs and symptoms of appendicitis, particularly in late pregnancy, due to many factors. For instance, the appendix can migrate cephalad with the enlarging uterus resulting in pain from appendicitis localizing to the mid or even upper right side of the abdomen.
The initial modality of choice for diagnostic imaging of the appendix in pregnancy is ultrasonography. Please note that if ultrasound examination is inconclusive for appendicitis, MRI is the preferred next test. Acute appendicitis is the most common general surgical problem encountered during pregnancy and occurs in 1/800 to 1/1,500 pregnancies.
Maintaining a high index of suspicion for appendicitis in pregnant patients with abdominal symptoms will help with early diagnosis and treatment. MRI is always available at Salem Health.
Rebarber, A. & Jacob, BP. Acute appendicitis in pregnancy. In: UpToDate, Lockwood CJ, Levine D, Weiser M & Eckler, K (Eds), UpToDate, Waltham, MA. (2016.)