Appendicitis in Pregnancy

Appendicitis can happen at any time, including in pregnancy, and it is the most common non-obstetric surgical emergency in pregnancy. Prompt diagnosis and treatment protect both you and your baby. This page explains how appendicitis presents in pregnancy, how it is diagnosed, and how it is treated in the UK.

Symptoms in pregnancy

Pain often starts around the umbilicus and moves to the lower right, though in pregnancy the appendix shifts upward, so pain may be higher than expected. Nausea, vomiting, loss of appetite, and fever may accompany it. The shifting position of the appendix in later pregnancy can make diagnosis harder. Never dismiss right-sided abdominal pain in pregnancy as normal; get assessed. If you think you may have appendicitis, do not take painkillers and wait to see if it passes. Masking the pain can delay diagnosis, and delay is the biggest risk in appendicitis in pregnancy.

Diagnosis

Blood tests, ultrasound, and sometimes MRI are used to diagnose appendicitis in pregnancy, with imaging chosen to avoid radiation. Ultrasound is first-line where possible, though views may be limited. MRI is increasingly used in UK practice where ultrasound is inconclusive. A surgical review will combine findings with your examination. Laparoscopy is usually safe in pregnancy, though the approach may vary depending on your gestation and the size of your uterus. Your surgical team will explain the technique and why it is appropriate for you.

Treatment

The standard treatment is surgical removal of the appendix, usually by laparoscopy in early pregnancy and sometimes open surgery later or if the appendix has burst. Delay risks rupture, peritonitis, and serious harm to you and your baby, so surgery is not delayed without reason. Antibiotics may be started before surgery. Your obstetric and surgical teams will coordinate care. After surgery, you may be monitored on the maternity ward rather than a surgical ward, so that foetal wellbeing can be checked alongside your recovery. This is standard and not a sign that something is wrong.

After surgery

Most women recover well and go on to have a normal pregnancy. Monitoring for contractions and foetal wellbeing is standard afterwards. Pain relief and mobility are balanced to prevent clots. Ask your team about your birth plan, as mode and timing may be reviewed but are often unaffected. Recovery is usually quick, and pregnancy outcomes are good when appendicitis is treated promptly. Most women who have their appendix removed in pregnancy go on to have normal births at term. The incision heals well, and future pregnancies are not usually affected. Your team will discuss any specific considerations at your follow-up.

This page is for general information only and does not replace advice from your UK maternity or mental health team. If you are worried about your physical or mental health in pregnancy, contact your midwife, GP, or call 111. In an emergency, call 999.