Predictors of true appendicitis in pregnancy: a pathology-based 10-year cohort study

To evaluate the diagnostic value of physical examination, ultrasonography (USG), and white blood cell (WBC) count in pregnant patients with suspected acute appendicitis and to determine which parameters are most significant in differentiating true appendicitis from non-appendicitis cases. This hospital-based study involved pregnant women who underwent surgery for suspected acute appendicitis. Data were collected from patient records, including physical examination findings, USG results, WBC counts, intraoperative and pathological findings, and hospital stay duration. Patients were divided into two groups based on pathological diagnosis: those with confirmed appendicitis and those without. A total of 106 pregnant women were included in the study. Physical examination revealed that rebound and defense signs were significantly higher in the appendicitis group (p < 0.001). USG correctly diagnosed appendicitis in 66% of cases in the appendicitis group compared to 28% in the non-appendicitis group (p = 0.003). The mean WBC count was significantly higher in the appendicitis group (14.30 ± 4.77) than in the non-appendicitis group (12.37 ± 4.29) (p = 0.040). The average length of hospital stay did not significantly differ between the two groups. Physical examination, USG, and WBC count are valuable diagnostic tools in differentiating true appendicitis from non-appendicitis cases in pregnant patients. Early diagnosis and timely surgical intervention can significantly reduce the risk of complications. However, a thorough evaluation is essential to minimize the risk of negative exploration.