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Unnecessary Laparotomies Prevented in Pregnant Women

MRI allows better identification of abnormal appendix in pregnant women

THURSDAY, Mar. 5 (HealthDay News) -- MRI can help to prevent unnecessary laparotomies in pregnant patients with suspected acute appendicitis, according to research published in the March issue of Radiology.

Ivan Pedrosa, M.D., of the Harvard Medical School in Boston, and colleagues retrospectively analyzed data from 148 pregnant women who had been clinically suspected of having acute appendicitis and subsequently were examined by MRI. Of these, 140 patients underwent ultrasonography prior to MRI. The mean gestational age was 20 weeks, and the mean patient age was 29 years.

A total of 14 patients had confirmed acute appendicitis and three patients experienced perforation, the researchers report. Ultrasonography results were positive for acute appendicitis in five, normal in seven and inconclusive in two of these patients. In contrast, MRI results were positive for all 14 patients, the investigators found. MRI identified two patients without appendicitis as positive, and seven as inconclusive. Among the patients without acute appendicitis, ultrasonography identified a normal appendix in less than 2 percent of cases, while normal appendices were identified in 87 percent of patients by MRI. The negative laparotomy rate was determined to be 30 percent, the report indicates.

"MRI has the potential to help reduce the negative laparotomy rate while maintaining an acceptable perforation rate in pregnant patients clinically suspected of having acute appendicitis," the authors conclude.

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