gynecology and obstetrics
Disorders Requiring Surgery During Pregnancy
Appendicitis
 Appendicitis may occur during pregnancy but is more common immediately postpartum. Because the appendix rises in the abdomen as pregnancy progresses, pain and tenderness may not occur in the classic right lower quadrant location, and pain may be mild and cramping, mimicking pregnancy-related symptoms. Also, the white blood cell (WBC) count is normally somewhat elevated during pregnancy, making the WBC count even less useful than usual. Serial clinical assessment and compression-graded ultrasonography are useful. Because diagnosis is often delayed, mortality rate from a ruptured appendix is increased during pregnancy and particularly postpartum. Thus, if appendicitis is suspected, surgical evaluation (laparoscopy or laparotomy depending on the stage of pregnancy) should proceed without delay. 