Elective appendectomy at the time of cesarean delivery: a randomized controlled trial.

Abstract

The purpose of this study was to compare postoperative morbidity in patients who underwent cesarean delivery with and without elective appendectomy. Subjects who underwent cesarean delivery were assigned randomly by computer-generated randomization to either standard cesarean delivery or cesarean delivery with appendectomy. Primary variables that were measured were operative times and markers of morbidity. Secondary outcome was appendiceal pathologic condition. Ninety-three subjects whose condition required cesarean delivery from July 2002 to May 2006 were enrolled (control subjects, 48; active subjects, 45). Operative time in the study group was increased by 8.8 minutes (P < or = .028). Postoperative morbidity findings were similar. Pathologic evaluation revealed 9 abnormalities that included acute appendicitis in 2 patients. Elective appendectomy at the time of cesarean delivery does not increase inpatient morbidity. Consideration can be given safely to elective appendectomy at the time of cesarean delivery in selected cases, such as women with palpable fecaliths and/or an abnormal appearing appendix, a history of pelvic pain, endometriosis, or anticipated intraabdominal adhesions.