Elective appendectomy at the time of cesarean delivery

a randomized controlled trial

Pearce, Christy MD
Torres, Carlos MD
Stallings, Shawn MD
Adair, David MD
Kipikasa, Joseph MD
Briery, Christian MD
Fody, Edward MD

¹Section on Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Holland, MI
²Holland Hospital, Holland, MI

Cite this article as: Pearce C, Torres C, Stallings S, et al. Elective appendectomy at the time of cesarean delivery: a randomized controlled trial. Am J Obstet Gynecol 2008;199:491.e1-491.e5.

Reprints not available from the authors.

This study was presented at the 27th Annual Clinical Meeting of the Society for Maternal-Fetal Medicine, San Francisco, CA, Feb. 5-10, 2007.

Received Aug. 3, 2007; accepted March 25, 2008

American Journal of Obstetrics and Gynecology 199(5):p 491e1-491e5, November 2008.

OBJECTIVE:

The purpose of this study was to compare postoperative morbidity in patients who underwent cesarean delivery with and without elective appendectomy.

STUDY DESIGN:

Subjects who underwent cesarean delivery were assigned randomly by computer-generated randomization to either standard cesarean delivery or cesarean delivery with appendectomy. Primary variables that were measured were operative times and markers of morbidity. Secondary outcome was appendiceal pathologic condition.

RESULTS:

Ninety-three subjects whose condition required cesarean delivery from July 2002 to May 2006 were enrolled (control subjects, 48; active subjects, 45). Operative time in the study group was increased by 8.8 minutes (P ≤ .028). Postoperative morbidity findings were similar. Pathologic evaluation revealed 9 abnormalities that included acute appendicitis in 2 patients.

CONCLUSION:

Elective appendectomy at the time of cesarean delivery does not increase inpatient morbidity. Consideration can be given safely to elective appendectomy at the time of cesarean delivery in selected cases, such as women with palpable fecaliths and/or an abnormal appearing appendix, a history of pelvic pain, endometriosis, or anticipated intraabdominal adhesions.