Comparative Evaluation of Laparoscopic and Open Appendectomy During Pregnancy: Maternal and Fetal Outcomes

Background: Acute appendicitis is one of the most common non-obstetric surgical emergencies during pregnancy, and the choice of laparoscopic and open appendectomies depends on the maternal and fetal outcomes. This study compared perioperative, postoperative, obstetric, and fetal/neonatal outcomes in patients with laparoscopic appendectomy and open appendectomy during pregnancy. Material and Methods: This study conducted a comparative observational study of 50 pregnant women who underwent laparotomy for the treatment of acute appendicitis in a tertiary care hospital from June 2024 to June 2026. Patients were randomly assigned to the laparoscopic appendectomy group (LA; n = 25) and the open appendectomy group (OA; n = 25). Demographic, clinical, operative, postoperative, maternal obstetric, and fetal/neonatal data were collected. Continuous variables are described as mean ± SD, while categorical variables are presented as counts and percentages. Statistical analyses were performed with appropriate t-tests, chi-square tests, or Fisher's exact tests. A value of p < 0.05 was considered statistically significant. Results: The mean age and gestational age were 27.50 ± 3.54 years and 18.56 ± 5.21 weeks, respectively. The LA group showed a longer operative time in comparison with the OA group (54.8 ± 11.6 vs 46.2 ± 10.4 minutes) but lower intraoperative blood loss (24.8 ± 8.7 vs 31.6 ± 10.2 mL). The LA group had a lower level of postoperative pain, earlier mobilization and oral intake, and shorter hospital stay (3.4 ± 1.1 vs 5.0 ± 1.4 days). The maternal obstetric and fetal/neonatal outcomes were similar in groups. Conclusion: Laparoscopic appendectomy was associated with better postoperative recovery without affecting the maternal and fetal outcomes.

Keywords: Acute appendicitis, Pregnancy, Laparoscopic appendectomy, Open appendectomy, Maternal and fetal outcomes.