Appendicitis is inflammation of the appendix. This is the most common pathology during pregnancy and requires surgery to be "cured"; it usually affects one in 1,000 pregnant women. It is more common in the first two trimesters of pregnancy, although it can also occur in the last trimester. If you are pregnant and worried about having appendicitis, you need to go to the emergency room right away.
Steps
Part 1 of 3: Recognizing the Symptoms
Step 1. Know the typical symptoms of this inflammation
These are:
- Abdominal pain that often begins in the central area of the abdomen near the navel and gradually, over a few hours, can move to the right area (this is the most worrying sign, which may indicate that it is precisely appendicitis).
- Nausea and / or vomiting (beyond what you can usually experience during pregnancy).
- Fever.
- Lack of appetite.
Step 2. Pay attention to any pain
The most precise indication, which may lead you to think that it is appendicitis, is a pain that starts quite dull in and around the navel, which within a few hours tends to move to the right abdominal area and becomes more intense.
- The "classic" pain of appendicitis occurs in the area 2/3 between the navel and the hip bone (this area is called McBurney's point).
- If you have appendicitis and try to lie down on the right side of your body, you may feel more severe pain. Pain may be present even if you stand or walk.
- Some women may experience pain when standing if their round ligament is too tight (not unusual during pregnancy). However, this type of pain usually goes away within a short time. That of appendicitis, on the other hand, does not resolve itself, which allows you to differentiate the two problems.
Step 3. Be aware that you may experience upper body pain when you are in the third trimester
Women who are past 28 weeks of pregnancy may feel pain just below the lower rib on the right side of the body. This is due to the fact that the uterus enlarges with the development of the fetus thus displacing the appendix. This, instead of being in McBurney's point, between the navel and the right hip, moves upwards and is pushed right under the rib cage, always on the right side of the body.
Step 4. Pay attention to whether the pain is followed by vomiting and a feeling of nausea
As you may have already experienced, vomiting and pregnancy go hand in hand. However, if you have appendicitis, you feel the pain first and then you vomit (or the nausea and vomiting are worse if you compare them to what you previously experienced).
Also, if you are in the late stages of pregnancy (when the discomfort related to hormonal changes has passed) and you continue to vomit and feel nauseous, it is very likely that it is appendicitis
Step 5. Check if your body temperature has suddenly risen
In cases of appendicitis, this symptom is completely normal. Not very high fever itself should not be of particular concern. However, if it is accompanied by pain and vomiting, you should be alarmed. If you are experiencing all three of these symptoms at the same time, you should see a doctor.
Step 6. Also pay attention if you experience paleness, sweating or loss of appetite
Both paleness and sweating can be a consequence of the nausea and fever caused by the inflammation of the appendix. Loss of appetite is a symptom that occurs in all people who have appendicitis, not just those who are pregnant.
Part 2 of 3: Undergo a Physical Exam
Step 1. Stay calm and prepare for your visit to the doctor
Going to the doctor, especially in a particularly stressful situation like this, can put a strain on your strength, determination and can be quite unnerving. Therefore, it is certainly useful to know in advance what awaits you. The doctor will perform an abdominal exam which will take place as described below.
The ideal would be to go to the emergency room. Appendicitis is inflammation that requires prompt medical intervention, so the best thing is to be already in the hospital, where all the necessary tests can be done promptly
Step 2. Do not take painkillers before going to the doctor
Even if you are experiencing pain, keep in mind that this is one of the things your doctor must check in order to diagnose the problem, but if you take medications that reduce it, you can mislead the diagnosis.
Step 3. Do not eat, drink or take laxatives before going to the doctor
Most people go to the emergency room when they are concerned that it may be appendicitis, so waiting times shouldn't be too long.
The reason you need to refrain from eating or drinking is that some procedures and tests need to be done on an empty stomach. Also, by doing this, you lighten the digestive system and reduce the chances that the appendix can burst, if it is actually inflamed
Step 4. Know that your doctor will do a test to check for pain in the abdomen
There are several tests to determine the causes of abdominal pain you feel, so you can understand if it is actually appendicitis or some other ailment. It can start with some pressure on the abdomen to stimulate the painful area, as well as tapping or testing for "rebound pain" (pain that occurs after releasing pressure with the hands).
The various tests may seem redundant and take a long time, but keep in mind that they are important for the doctor to understand exactly the type of pathology
Step 5. Be prepared that you will be able to be tested for hip rotation
This test aims to look for the "obturator sign", which is the pain that occurs when the hip is rotated. The doctor supports the knee and right ankle and then bends the knee and hip as he rotates the leg in and out. Watch out for any pain in the lower right quadrant of your abdomen and tell your doctor right away if that area hurts, as it could mean obturator muscle irritation, a typical sign of appendicitis.
Step 6. Expect a leg extension exam
Your doctor may ask you to lie on one side of your body and will stretch your legs to check if you are in pain. This is called the "psoas test", and if you experience increased pain, it is another sign that the appendix is inflamed.
Step 7. Be prepared for a possible rectal exam
Although this type of test is not strictly related to the diagnosis of appendicitis, many doctors believe it is useful in ruling out the possibility of other possible pathologies. Therefore, don't be surprised if your doctor decides to perform this test during your visit.
Part 3 of 3: Medical Tests to Confirm the Diagnosis
Step 1. Prepare to undergo a blood test
The white blood cell count is usually very high in the presence of appendicitis. However, this test proves less useful in pregnant women than in other patients, as white blood cells are still higher in pregnant women and therefore are not always clear indicators of appendicitis.
Step 2. Ask your doctor about the ultrasound
This is the "best" (and most recommended) test for diagnosing appendicitis in pregnant women. An ultrasound instrument uses the echo of waves hitting the body to create an image and facilitate the diagnosis of appendicitis.
- People who go to the emergency room because of a suspicion of appendicitis usually get a CT scan. However, many doctors prefer to perform ultrasound in pregnant women, as this test is not harmful to the baby.
- Ultrasound is able to successfully identify the majority of cases of appendicitis.
Step 3. Be available to perform other possible imaging tests as well
After the 35th week of pregnancy, all imaging tests become complex and ineffective due to the increased volume of the abdomen, which makes it difficult to see the appendix accurately.
During this time, your doctor may recommend that you do a CT scan or MRI to better see if the appendix is inflamed
Advice
- Any unexplained forms of pain or fever that occur during pregnancy should be carefully evaluated or at least discussed with your doctor. Most obstetric clinics have a medical service available 24 hours a day 7 days a week to answer these questions.
- Check for symptoms over time, the most reliable indicator of appendicitis is abdominal pain that develops around the navel and gradually moves to the right side.
- Stay calm and ask your partner to accompany you to the emergency room so they can reassure you during the visit.
Warnings
- It is not easy to diagnose appendicitis in a pregnant woman, as the pain may not be in the typical spot.
- If your appendix breaks during the third trimester, then you will need to have an emergency caesarean section to protect your life and that of your baby. At this stage of gestation the baby is old enough to be born and face the outside world.
- If you experience sharp pain that doesn't go away, go to the emergency room. You should always rely on an experienced doctor to understand the type of problem you are experiencing.
