Evidence map›Paper›PMID 39441538›Full record

Observational studyInternational journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics2025

Impact of gestational age on the management of acute appendicitis during pregnancy: A nationwide observational study.

Shunya Sugai, Yusuke Sasabuchi, Hideo Yasunaga, Shotaro Aso, Hiroki Matsui, Kiyohide Fushimi, Kosuke Yoshihara, Koji Nishijima

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. 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 · 2025
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Shunya SugaiDepartment of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata, Japan.ORCID https://orcid.org/0000-0002-5245-2311
Yusuke SasabuchiDepartment of Real-World Evidence, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Hideo YasunagaDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
Shotaro AsoDepartment of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Hiroki MatsuiDepartment of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
Kiyohide FushimiDepartment of Health Policy and Informatics, Institute of Science Tokyo Graduate School of Medical and Dental Sciences, Tokyo, Japan.
Kosuke YoshiharaDepartment of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata, Japan.
Koji NishijimaDepartment of Obstetrics and Gynecology, Niigata University Medical and Dental Hospital, Niigata, Japan.ORCID https://orcid.org/0000-0003-2050-5543

Funding

Ministry of Health, Labour and Welfare 22AA2003Ministry of Health, Labour and Welfare 23AA2003
6 · The paper itself

Abstract

objectiveTo compare conservative management and appendectomy for acute appendicitis during pregnancy by trimester.

methodsThis retrospective cohort study used data from a national inpatient database from July 2010 to March 2022. Pregnant women diagnosed with acute appendicitis were included. Multivariable analysis using generalized estimating equations was performed to compare outcomes between conservative management and appendectomy across trimesters. The main outcomes were preterm labor, preterm delivery, or abortion; antepartum hemorrhage; duration of hospitalization; and duration of antibiotic use.

resultsA total of 3158 individuals from 632 acute-care hospitals were eligible. The proportion of conservative management versus appendectomy by trimester were 507 (49.1%) versus 525 (50.9%) in the first, 690 (44.6%) versus 856 (55.4%) in the second, and 337 (58.1%) versus 243 (41.9%) in the third. In the second trimester, appendectomy was associated with a higher rate of preterm delivery, preterm labor, or abortion (odds ratio [OR], 2.91 [95% confidence interval (CI), 1.62-5.25]). Antepartum hemorrhage occurred more frequently for appendectomy in the first (OR, 2.12 [95% CI, 1.31-3.43]) and third (OR, 2.43 [95% CI, 1.79-3.31]) trimesters. Appendectomy was associated with a longer duration of hospitalization in the second (2.15 days; 95% CI, 1.14-3.17 days) and third (3.97 days; 95% CI, 2.22-5.71 days) trimesters. Antibiotic use duration was shorter for appendectomy in the first (-1.20 days [95% CI -1.51 to -0.90 days]) and second (-0.61 days [95% CI -0.90 to -0.32 days]) trimesters.

conclusionsClinical outcomes of acute appendicitis during pregnancy vary by trimester. Considering the appendectomy risks, conservative management may be viable depending on the clinical context and trimester.

Indexed as

AppendectomyAppendicitisConservative TreatmentGestational AgePregnancy ComplicationsAcute DiseaseAdultAnti-Bacterial AgentsFemaleHumansLength of StayObstetric Labor, PrematurePregnancyPregnancy OutcomePregnancy TrimestersPremature BirthAnti-Bacterial Agentsabortionacute appendicitisantibioticsappendectomyconservative managementlength of staypremature birth

Identifiers

PMID39441538
PMCPMC11823319

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.