Potential of ultrasound in the evaluation of acute appendicitis during pregnancy: a systematic review and meta-analysis

Abstract

Potential of ultrasound in the evaluation of acute appendicitis during pregnancy: a systematic review and meta-analysis Yunlong Li1 , Shikuan Li1,* 1Department of Emergency General Surgery, the Affiliated Hospital of Qingdao University, 266003 Qingdao, Shandong, China *Correspondence: worldwidth@aliyun.com (Shikuan Li) Academic Editor: Michael H. Dahan Submitted: 18 March 2021 Revised: 29 May 2021 Accepted: 8 June 2021 Published: 12 January 2022 Abstract Objective: To assess the accuracy of ultrasound in diagnosing acute appendicitis in pregnant women. Mechanism: The National Library of Medicine (MEDLINE, 1990–2020), Excerpta Medica Database (EMBASE,1946–2020) and the Cochrane Controlled Trials Register (CENTRAL) were used to extract articles that were published in English. A total of five studies involving 521 patients were selected. The DerSimonian and Laird random-effects model and Quality Assessment Tool for Diagnostic Accuracy (QUADAS-2) were used to analyze the data. Findings in brief: We identified 140 related articles and included 5 articles enrolling 521 patients. The values obtained using ultrasound for appendicitis during pregnancy were sensitivity of 0.62 (95% Confidence interval (CI): 0.43–0.78), the specificity of 0.91 (95% CI: 0.74–0.97), and the Positive Likelihood Ratio of 7.0 (95% CI: 2.5–19.7), the Negative Likelihood Ratio of 0.41 (95% CI: 0.27–0.63) and the Diagnostic Odds Ratio of 17 (95% CI : 6–49). Conclusion: Ultrasound had medium-level sensitivity and high specificity for the diagnosis of appendicitis in pregnant women. Keywords: Acute appendicitis; Ultrasound; Diagnostic study; Pregnancy; Meta-analysis