Elective appendectomy at the time of cesarean delivery: a randomized controlled trial

Pearce C, Christy Pearce, Carlos Torres, Torres C, Shawn Stallings, Stallings S, Adair D, David Adair, Kipikasa J, Joseph Kipikasa, Christian Briery, Briery C, Edward P. Fody, Fody E, Edward Fody
American journal of obstetrics and gynecology · 2008 · vol. 199(5) , pp. 491.e1–491.e5 · doi:10.1016/j.ajog.2008.03.063 · PMID:18486093 · W2106971486
article OA: closed CC0 ⤵ 2 in-corpus citations
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This RCT found that elective appendectomy during cesarean delivery, while increasing operative time slightly, did not increase postoperative morbidity, with 9 abnormalities found in 45 appendices.

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Abstract

ObjectiveThe purpose of this study was to compare postoperative morbidity in patients who underwent cesarean delivery with and without elective appendectomy.Study designSubjects 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.ResultsNinety-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 < or = .028). Postoperative morbidity findings were similar. Pathologic evaluation revealed 9 abnormalities that included acute appendicitis in 2 patients.ConclusionElective 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.

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MeSH descriptors

Appendectomy Cesarean Section Elective Surgical Procedures Adult Appendix Appendix Female Humans Postoperative Complications Pregnancy

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