MRI Use and Pregnant Patients with Suspected Appendicitis

Magnetic resonance imaging in pregnant patients with suspected appendicitis allows for safe discharge from the emergency department and improves resource use, according to an article published in JAMA Surgery.

Researchers from Yale School of Medicine in New Haven, Conn., performed a retrospective review of 79 pregnant women who presented with abdominal pain and suspected appendicitis and who were followed through delivery. Thirty-four patients had pathology that confirmed appendicitis. The researchers looked at time to surgery, length of stay, complications, nontherapeutic explorations, fetal outcomes and hospital charges.

Thirty-one patients underwent MR imaging. The researchers noted there were fewer surgeries among the patients who underwent MR imaging. There was one nontherapeutic exploration in the MR imaging group versus seven nontherapeutic explorations in the non-MR imaging group. Patients in the MR imaging group were also more frequently discharged from the emergency department and had shorter length of stays (33.7 versus 64.8 hours).[[{"type":"media","view_mode":"media_crop","fid":"25876","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_8048757279757","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2428","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"line-height: 1.538em; height: 148px; width: 200px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":" ","typeof":"foaf:Image"}}]]

There were no differences between the groups regarding gestational age, time to surgery and the presence of perforated appendicitis. There was one fetal loss in the non-MR imaging group. No patients from either group who were discharged without surgery returned with appendicitis. The mean hospital charges were similar in both groups.

The researchers concluded that use of MR imaging in pregnant women with suspected appendicitis allowed safe discharge from the emergency department and did not affect clinical outcome or hospital charges.