Morbidity of Appendectomy and Cholecystectomy in Pregnant and Nonpregnant Women

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 118; no. 6; pp. 1261 - 1270
• Main Authors: Silvestri, Mark T, Pettker, Christian M, Brousseau, E Christine, Dick, Madeline A, Ciarleglio, Maria M, Erekson, Elisabeth A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD The American College of Obstetricians and Gynecologists 01.12.2011; Lippincott Williams & Wilkins
• Subjects: Adult; Appendectomy; Biological and medical sciences; Cholecystectomy; Female; Gynecology. Andrology. Obstetrics; Humans; Liver, biliary tract, pancreas, portal circulation, spleen; Medical sciences; Middle Aged; Postoperative Complications - epidemiology; Pregnancy; Pregnancy Complications - surgery; Retrospective Studies; Stomach, duodenum, intestine, rectum, anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Young Adult; Cholecystectomy; Human; Appendectomy; Prognosis; Gynecology; Obstetrics; Morbidity; Pregnancy; Treatment; Vermiform appendix; Surgery; Female; Gallbladder; Woman
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/AOG.0b013e318234d7bc

OBJECTIVE:To use the data from the American College of Surgeons (ACS) National Surgical Quality Improvement Program to estimate major postoperative morbidity after 1) appendectomy in pregnant compared with nonpregnant women; and 2) cholecystectomy in pregnant compared with nonpregnant women. METHODS:We selected a cohort of reproductive-aged women undergoing appendectomy and cholecystectomy between 2005 and 2009 from the data files of the ACS National Surgical Quality Improvement Program. Outcomes in pregnant women were compared with those in nonpregnant women. The primary outcome was composite 30-day major postoperative complications. Pregnancy-specific complications were not assessed and thus not addressed. RESULTS:Pregnant and nonpregnant women had similar composite 30-day major morbidity after appendectomy (3.9% [33 of 857] compared with 3.1% [593 of 19,172], P=.212) and cholecystectomy (1.8% [eight of 436] compared with 1.8% [584 of 32,479], P=.954). Pregnant women were more likely to have preoperative systemic infections before each procedure. In logistic regression analysis, pregnancy status was not predictive of increased postoperative morbidity for appendectomy (adjusted odds ratio 1.26, 95% confidence interval 0.87–1.82). CONCLUSION:Pregnancy does not increase the occurrence of postoperative maternal morbidity related to appendectomy and cholecystectomy. LEVEL OF EVIDENCE:II