DIAGNÓSTICO E MANEJO CIRÚRGICO DO APENDICITE EM GESTANTES: UMA REVISÃO INTEGRATIVA

Abstract

Introduction: Acute appendicitis is the most common surgical cause of abdominal pain in pregnant women, presenting significant challenges for diagnosis and treatment during pregnancy. Classic symptoms, such as abdominal pain and nausea, can be confused with common physiological changes during pregnancy, making an early diagnosis difficult. Inadequate treatment can lead to serious complications, including rupture of the appendix and increased risks for mother and fetus. This article aims to analyze the methods recommended for the diagnosis and surgical management of appendicitis in pregnant women, highlighting safe and effective techniques. Methodology: An integrative literature review was carried out with 10 articles selected from the Virtual Health Library (VHL) and SciELO, using descriptors such as “Appendicitis”, “Pregnant women” and “Surgery”. The inclusion criteria considered complete, freely accessible articles published between 2000 and 2024. The selection followed a rigorous screening process and complete reading of the texts. Results and Discussion: The diagnosis of appendicitis in pregnant women is complex due to anatomical changes that can mask clinical signs. Ultrasonography is the preferred imaging technique, although MRI has proven useful in inconclusive cases, avoiding exposure to radiation. Both laparotomy and laparoscopy are viable options for treatment, with laparoscopy generally preferred due to its minimally invasive benefits, although the risks in pregnant women advance the discussion on the choice of technique. Studies highlight that early surgery is crucial to reduce maternal and fetal complications. Delays in diagnosis can result in severe complications, increasing the risk of premature birth and maternal mortality. The choice of surgical technique must be individualized, taking into account the surgeon's experience and the patient's clinical conditions. Conclusion: The review shows that, despite the challenges in diagnosing and managing appendicitis in pregnant women, techniques such as ultrasound and laparoscopy offer safe paths to treatment. However, the lack of randomized clinical trials limits the generalization of results. Therefore, more research is needed to provide evidence-based guidelines to improve outcomes for pregnant women and fetuses. Continued advancement in research is vital to improving obstetric and surgical care.