Appendicitis is inflammation of the appendix. It is the most common condition in pregnancy that requires surgery "as a cure," and it occurs in about 1/1000 pregnancies. Pregnant women generally experience appendicitis during the first two trimesters of pregnancy; however, it can also occur in the last trimester. If you are pregnant and worried that you may have appendicitis, see your doctor right away.

Recognizing the Symptoms of Appendicitis
1. Know the common symptoms of appendicitis.

2. Monitor any pain you feel. The most reliable sign of appendicitis is pain that starts out dull in and around your belly button and, after a few hours, shifts over to the right side and becomes more intense.

3. Be aware that you may feel pain higher up in your body if you are in your third trimester.

4. Pay attention if the pain you feel is followed by vomiting and nausea.

5. Be aware if you suddenly develop a fever. When you have appendicitis, a low grade fever usually develops.



6. Monitor any paleness, sweating, or lack of appetite that you experience.

Undergoing a Physical Examination
1. Stay calm and prepare for the visit to your doctor. Going to the doctor, especially in a stressful situation like this one, can be nerve-wracking so it is best to know what you are going to experience. The abdominal exams your doctor will perform are listed in the following steps.

2. Avoid taking pain medications before going to see your doctor. While you will be experiencing pain, that pain is one of the only ways doctors can diagnose appendicitis in pregnant women so masking it with medication could be detrimental.

3. Do not eat, drink, or take any laxatives before seeing your doctor. Most people see a physician in the emergency room when they are worried about appendicitis, so the wait shouldn't be too long.

4. Know that your doctor will feel around your stomach testing for pain.

5. Be prepared for a rotation of the hip test.

6. Expect a leg extension test. Your doctor will ask you to lie on your side, and he or she will extend your leg asking if you feel pain. This is called the "Psoas test" and, when positive for increased pain, it is another indicator of appendicitis.

7. Be ready for a rectal exam. Although the rectal exam does not relate directly to the diagnosis of appendicitis, many physicians have been trained to do it as a way to exclude the possibility of something else going on.

Using Medical Tests to Confirm the Diagnosis
1. Be ready to get some blood work done. Your white blood cell counts are usually elevated with appendicitis. However, this test is less helpful in pregnant women than in other patients; this is because your white blood cell counts are already increased in pregnancy, so it does not necessarily indicate appendicitis.

2. Ask your doctor for an ultrasound. Ultrasound is the "gold standard" (most highly recommended) diagnostic test for appendicitis in pregnant women. It uses ultrasound echoes to create a picture and to help doctors see if you have an inflamed appendix.

3. Be open to the possibility of other imaging tests. After 35 weeks of pregnancy, all imaging tests become complicated because of the size of the pregnancy making it hard to see the appendix.