GuidelineSurgical endoscopy2022
EAES rapid guideline: systematic review, meta-analysis, GRADE assessment, and evidence-informed European recommendations on appendicitis in pregnancy.
Guideline in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 4 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Trimester-specific safety of laparoscopic versus open abdominal surgery during pregnancy: systematic review and meta-analysis.The British journal of surgery · 2026Pooled it
- Swedish national guidelines for diagnosis and management of acute appendicitis in adults and children.BJS open · 2025Guideline
- Society of American Gastrointestinal and Endoscopic Surgeons guidelines development: patient engagement update to standard operating procedure.Surgical endoscopy · 2025Guideline
- SAGES guidelines for the use of laparoscopy during pregnancy.Surgical endoscopy · 2024Guideline
- Gestational Age-Adapted Laparoscopic Appendectomy for Acute Appendicitis during Pregnancy: Intraoperative Strategies and Outcomes from a Single-Center Case Series.Surgical case reports · 2026Article
- Abdominal wound dehiscence after appendectomy during pregnancy treated by negative pressure wound therapy with subsequent vaginal delivery: A case report and literature review.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Review
- Appendicitis in Pregnancy: A Multidisciplinary Approach and Optimal Management from the Perspective of Gynecology and Obstetrics - A Case Report.Visceral medicine · 2025Article
- Impact of gestational age on the management of acute appendicitis during pregnancy: A nationwide observational study.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2025Observational
- Management of acute appendicitis in pregnancy (MAMA): Protocol for a multicentre observational study.PloS one · 2025Article
- Review
- Is Appendectomy During Late Stages of Pregnancy Associated with an Increased Cesarean Delivery Rate? - a Retrospective Analysis of One Center During 10 Years.Geburtshilfe und Frauenheilkunde · 2024Article
- Pregnant patients requiring emergency general surgery: a scoping review of diagnostic and management strategies.Canadian journal of surgery. Journal canadien de chirurgieArticle
Corrections and comments
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Authors and funding
17 authors at 13 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical practice recommendations for the management of acute appendicitis in pregnancy are lacking.
objectiveTo develop an evidence-informed, trustworthy guideline on the management of appendicitis in pregnancy. We aimed to address the questions of conservative or surgical management, and laparoscopic or open surgery for acute appendicitis.
methodsWe performed a systematic review, meta-analysis, and evidence appraisal using the GRADE methodology. A European, multidisciplinary panel of surgeons, obstetricians/gynecologists, a midwife, and 3 patient representatives reached consensus through an evidence-to-decision framework and a Delphi process to formulate the recommendations. The project was developed in an online authoring and publication platform (MAGICapp).
resultsResearch evidence was of very low certainty. We recommend operative treatment over conservative management in pregnant patients with complicated appendicitis or appendicolith on imaging studies (strong recommendation). We suggest operative treatment over conservative management in pregnant patients with uncomplicated appendicitis and no appendicolith on imaging studies (weak recommendation). We suggest laparoscopic appendectomy in patients with acute appendicitis until the 20th week of gestation, or when the fundus of the uterus is below the level of the umbilicus; and laparoscopic or open appendectomy in patients with acute appendicitis beyond the 20th week of gestation, or when the fundus of the uterus is above the level of the umbilicus, depending on the preference and expertise of the surgeon.
conclusionThrough a structured, evidence-informed approach, an interdisciplinary panel provides a strong recommendation to perform appendectomy for complicated appendicitis or appendicolith, and laparoscopic or open appendectomy beyond the 20th week, based on the surgeon's preference and expertise. GUIDELINE REGISTRATION NUMBER: IPGRP-2022CN210.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.