PARAMETERS ASSOCIATED WITH ACUTE APPENDICITIS IN PREGNANCY

Year 2023, Volume: 30 Issue: 2, 185 - 191, 22.06.2023

Samet Şahin , Eyüp Murat Yılmaz , Mahir Kırnap , Ethem Bilgiç , Ahmet Ender Demirkıran

https://doi.org/10.17343/sdutfd.1240578

Abstract

Objective
Acute appendicitis is the most common cause of nonobstetric
acute abdomen in pregnant women. The
fact that sympathomatology brings to mind primarily
obstetric causes in pregnant patients, physiological
leukocytosis is observed throughout pregnancy, and
limitations in imaging methods cause confusion in the
diagnosis. This makes the need for detailed evaluation
in laboratory parameters inevitable. The aim of
the study is to reveal the relationship of laboratory
parameters such as neutrophil lymphocyte ratio
(NLR), platelet lymphocyte ratio (PLR), lymphopenia
with the diagnosis of appendicitis and its diagnostic
power.
Material and Method
In the evaluation of 31 patients who were operated
on with the diagnosis of acute appendicitis during
pregnancy between January 2017 and February
2021 were evaluated. Correlation and roc analysis
were performed by evaluating patients' demographic
data, laboratory results, ultrasonography or magnetic
resonance imaging reports and intraoperative
findings.
Results
A significant correlation was found between
detection of appendicitis in exploration and increased
neutrophils, leukocytosis, and NLR (p: 0.014, p:
0.015, p: 0.020, respectively). Again, the presence
of lymphopenia, high NLR and increased palletelet /
lymphocyte ratio (PLR) were found to be associated
with prolonged hospitalization (p:0.037, p:0.008, and
p:0.024, respectively). Roc analysis also showed that
leukocytosis [AUC: 0.938 (95%CI: 0-1.00, p:0.019)],
neutrophil elevation [AUC: 0.938 (95%CI: 0-1.00,
p:0.019)] and NLR [AUC: 0.917 (0-1.00 p: 0.025)]
was found to have the power to reveal the presence
of significant acute appendicitis.
Conclusion
It is recommended to use hemogram parameters and
imaging methods effectively in the diagnosis of acute
appendicitis in pregnants.

Keywords

pregnancy, acute appendicitis, appendectomy

Supporting Institution

yok

Project Number

yok

Thanks

I would like to thank the editorial team and the referees in advance for their valuable comments and contributions.

GEBELIKTE AKUT APANDISITLE İLIŞKILI PARAMETRELER

Abstract

Amaç
Akut apandisit, gebelerde obstetrik olmayan akut batının
en sık nedenidir. Gebe hastalarda sempatomatolojinin
akla ilk olarak obstetrik nedenleri getirmesi,
fizyolojik lökositozun gebelik boyunca görülmesi ve
görüntüleme yöntemlerindeki kısıtlılıklar tanıda kafa
karışıklığına neden olmaktadır. Bu durum laboratuvar
parametrelerinde ayrıntılı değerlendirme ihtiyacını kaçınılmaz
kılmaktadır. Çalışmanın amacı nötrofil lenfosit
oranı (NLR), trombosit lenfosit oranı (PLR), lenfopeni
gibi laboratuvar parametrelerinin apandisit tanısı
ile ilişkisini ve tanısal gücünü ortaya koymaktır.
Gereç ve Yöntem
Değerlendirmede Ocak 2017-Şubat 2021 tarihleri arasında
gebelikte akut apandisit tanısı ile opere edilen
31 hasta değerlendirildi. Hastaların demografik verileri,
laboratuvar sonuçları, ultrasonografi veya manyetik
rezonans görüntüleme raporları ve intraoperatif
bulguları değerlendirilerek korelasyon ve roc analizi
yapıldı.
Bulgular
Eksplorasyonda apandisit saptanması ile nötrofil, lökositoz
ve NLR artışı arasında anlamlı bir ilişki bulundu
(sırasıyla p: 0,014, p: 0,015, p: 0,020). Yine
lenfopeni varlığı, yüksek NLR ve artmış palet/lenfosit
oranı (PLR) uzamış yatış ile ilişkili bulundu (sırasıyla,
p:0,037, p:0,008, p:0,024). Roc analizi ayrıca lökositoz
[AUC: 0,938 (%95 CI: 0-1,00, p:0,019)], nötrofil
yüksekliği [AUC: 0,938 (%95 CI: 0-1,00, p:0,019)]
ve NLR [AUC: 0,917 (0-1,00 p: 0,025)] anlamlı akut
apandisit varlığını ortaya koyma gücüne sahip olduğu
bulundu.
Sonuç
Gebelerde akut apandisit tanısında hemogram parametrelerinin
ve görüntüleme yöntemlerinin etkin bir
şekilde kullanılması önerilmektedir.

Keywords

gebelik, akut apandisit, appendektomi

Project Number

yok

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